O.A. Alexandrov, O.V. Pikin, A.B. Ryabov, S.O. Stepanov
Р.A. Herzen Moscow Oncology Research Center ― Branch of the National Medical Research Radiological Centre, Moscow
Alexandrov O.A. ― Junior researcher of the Department of thoracic surgery of Р.A. Herzen Moscow Oncology Research Center ― Branch of the National Medical Research Radiological Centre
3 2nd Botkinskiy Ave., Moscow, Russian Federation, 125284, tel. (495) 945-80-20, e-mail: oleg.alexandrov@icloud.com, ORCID ID: 0000-0002-4131-9179
Abstract
Aim of the study ― comparative study of two main techniques of mediastinal tumours biopsies ― transthoracic ultrasound guided biopsy and parasternal mediastinotomy.
Material and methods. Results of 89 transthoracic ultrasound guided biopsies and 89 parasternal mediastinotomies, conducted in 157 patients for 10-year period are presented.
Results. Adequate tissue samples for diagnosis has been obtained in 67 patients (84%) in ultrasound guided biopsy group and in 76 (99%) patients in whom parasternal mediastinotomy was performed. In 13 cases in ultrasound guided cases due to low quality of material parasternal mediastinotomy was performed. In all cases diagnosis was established. In 3 patients after parasternal mediastinotomy we had to repeat the procedure to obtain adequate tissue samples. In our study sensitivity of transthoracic ultrasound guided biopsy in patients with lymphoma was 81%, parasternal mediastinotomy ― 100%, specifity ― 86% and 92%. The efficacy of second transthoracic biopsy guided by ultrasound was equal to 20%.
Conclusion. Transthoracic ultrasound guided biopsy is a safe and reliable method with high diagnostic accuracy. In patients with complications, especially with superior vena cava syndrome, parasternal mediastinotomy is recommended.
Key words: tumour of mediastinum, biopsy, transthoracic ultrasound guided biopsy, parasternal mediastinotomy.