Chest ACCP Career Connection
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (7)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gossot, D.
Right arrow Articles by Grunenwald, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gossot, D.
Right arrow Articles by Grunenwald, D.
(Chest. 2001;120:289-294.)
© 2001 American College of Chest Physicians

Thoracoscopy or CT-Guided Biopsy for Residual Intrathoracic Masses After Treatment of Lymphoma*

Dominique Gossot, MD; Philippe Girard, MD, FCCP; Eric de Kerviler, MD; Pauline Brice, MD; Jean-Didier Rain, MD; Thierry Leblanc, MD and Dominique Grunenwald, MD

* From the Thoracic Department (Drs. Gossot, Girard, Grunenwald), Institut Mutualiste Montsouris; and Departments of Radiology (Dr. de Kerviler), Haematology (Drs. Brice and Leblanc), and Nuclear Medicine (Dr. Rain), Hôpital Saint-Louis, Paris, France.

Correspondence to: Dominique Gossot, MD, Thoracic Department, Institut Mutualiste Montsouris, 42 Bd Jourdan, F-75014 Paris, France; e-mail: dominique.gossot{at}imm.fr

Background: An intrathoracic mass persists after completion of treatment in 20% of the patients treated for Hodgkin’s disease (HD) or non-Hodgkin’s lymphoma (NHL). Gallium scan and positron emission tomography allow for diagnosis in most cases. However, in some patients, a pathologic examination of the residual mass (RM) is required. The aim of this study was to evaluate the results of a thoracoscopic approach for intrathoracic RM, as compared with image-guided biopsies.

Patients and methods: From 1996 to 1998, 29 consecutive patients treated for NLH (n = 11) or HD (n = 18) were referred either to radiology (group R; n = 8) or to surgery (group S; n = 21) for biopsy of an intrathoracic RM. There were 13 male and 16 female patients ranging in age from 15 to 56 years (mean, 32 years). The reason for a biopsy was the inability to determine the nature of the RM by means of radiologic examination or scintigraphy. Biopsy was defined as successful when (1) residual lymphoma was found in the specimen, or (2) benign tissue was found and the patient remained disease-free after a minimal follow-up period of 12 months. A biopsy was defined as a failure when a local recurrence occurred in a patient with a diagnosis of benign lesion.

Results: No significant procedure-related complications occurred in either group. The mean follow-up was 26 months (range, 13 to 72 months). In group R, residual lymphoma was found in only one patient. In group S, residual lymphoma was found in seven patients (p = 0.5). In the seven patients of group R with a diagnosis of benign mediastinal lesion, two patients had a local recurrence and one had a recurrence within the abdomen. In the 15 patients of group S in whom no residual disease was found, 1 patient had an intrathoracic recurrence (p = 0.5) while 2 patients had recurrence in a remote site.

Conclusion: Despite the limited number of patients in this series, results suggest that a thoracoscopic approach yields better data than image-guided biopsies.

Key Words: Hodgkin’s disease • gallium scan • lymphoma • mediastinum • residual mass • thoracoscopy






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the American College of Chest Physicians.