Value and Implantation Risk of Thin Needle Aspiration Biopsy in The Diagnostic Malign Pulmonary Lesions

Aim: The aim of our study was to investigate the diagnostic value of fine needle aspiration biopsy in malignant lesions, compare the results obtained by a Chiba and an injection needle and determine whether or not malignant cells are implanted on the course of the needle. Material and Methods: Fine needle aspiration biopsy was done on the resected material from a total of 70 patients (67 male and 3 female) with a mean age of 58.17 years (range: 38-75 years) who underwent surgery for prediagnosed malignancy.For each surgically resected material, the cytological and histopathological findings of the internal aspirates from both the Chiba and injector needles as well as the smears from the external surfaces of these needles were compared. Results: Of the 70 biopsy materials obtained by the Chiba needle, malignancy was demonstrated in 58, benign lesions in one, while 11 were non-diagnostic. The results obtained with the injector needle revealed 58 malignancies, and 12, without any diagnosis. With both techniques, no false positive results were observed. The diagnostic sensitivity of the techniques was 84% and 82% for the Chiba and injector needles respectively. Examination of the smears obtained from the external surfaces revealed malignant cells in 45 (64.3%) of the 70 smears obtained with a Chiba needle and 42 (60%) of the 70 smears obtained with an injector needle. Conclusions: Fine needle aspiration is a method with high diagnostic value. It can be easily performed in selected cases with malignant pulmonary lesions. There were no significant differences between the two methods in terms of diagnostic yield. Any intervention targeting the tumor tissue, especially in advanced stage cellular and malignant tumors, carries a significant risk for implantation of malignant tumor cells on the course of the needle.