TY - JOUR
T1 - The diagnostic yield of ct-guided percutaneous lung biopsy in solid organ transplant recipients
AU - Hsu, Joe L.
AU - Kuschner, Ware G.
AU - Paik, Jane
AU - Bower, Natalie
AU - Vazquez Guillamet, Maria C.
AU - Kothary, Nishita
PY - 2012/7
Y1 - 2012/7
N2 - Background: Despite the widespread use of computed tomography (CT)-guided percutaneous lung biopsy (PLB) in immunocompetent patients, the diagnostic yield and safety in solid organ transplant (SOT) recipients is unknown. The purpose of this investigation was to determine the test performance of CT-PLB in SOT recipients. Methods: We performed a 10-yr single-center, retrospective analysis among heart, lung, kidney, and liver transplant recipients. We included all adult patients who underwent a PLB of a parenchymal lung nodule following their transplantation. Results: Within the study period, 1754 SOTs were performed, of which 45 biopsies met study criteria. Overall, the incidence of PLB in SOT was 3%. PLB established a diagnosis in 24 of 45 cases. The yield of PLB was better for combined biopsy technique (fine-needle aspiration biopsy [FNAB]) and core biopsy than for FNAB alone (odds ratio [OR]: 4.2, 95% confidence interval [CI]: 1.2, 15.6), and for lesions that were malignant (OR: 10.0, 95% CI: 1.8, 75.4) or caused by an invasive fungal infection (OR: 5.0, 95% CI: 1.1, 27.9). Complications occurred in 13% (6/45) of patients. Conclusion: CT-guided PLB is a safe modality that provides a moderate yield for diagnosing pulmonary nodules of malignant or fungal etiology in SOT recipients.
AB - Background: Despite the widespread use of computed tomography (CT)-guided percutaneous lung biopsy (PLB) in immunocompetent patients, the diagnostic yield and safety in solid organ transplant (SOT) recipients is unknown. The purpose of this investigation was to determine the test performance of CT-PLB in SOT recipients. Methods: We performed a 10-yr single-center, retrospective analysis among heart, lung, kidney, and liver transplant recipients. We included all adult patients who underwent a PLB of a parenchymal lung nodule following their transplantation. Results: Within the study period, 1754 SOTs were performed, of which 45 biopsies met study criteria. Overall, the incidence of PLB in SOT was 3%. PLB established a diagnosis in 24 of 45 cases. The yield of PLB was better for combined biopsy technique (fine-needle aspiration biopsy [FNAB]) and core biopsy than for FNAB alone (odds ratio [OR]: 4.2, 95% confidence interval [CI]: 1.2, 15.6), and for lesions that were malignant (OR: 10.0, 95% CI: 1.8, 75.4) or caused by an invasive fungal infection (OR: 5.0, 95% CI: 1.1, 27.9). Complications occurred in 13% (6/45) of patients. Conclusion: CT-guided PLB is a safe modality that provides a moderate yield for diagnosing pulmonary nodules of malignant or fungal etiology in SOT recipients.
KW - Invasive fungal disease
KW - Lung nodule
KW - Malignancy
KW - Percutaneous lung biopsy
KW - Solid organ transplantation
UR - http://www.scopus.com/inward/record.url?scp=84864917023&partnerID=8YFLogxK
U2 - 10.1111/j.1399-0012.2011.01582.x
DO - 10.1111/j.1399-0012.2011.01582.x
M3 - Article
C2 - 23050274
AN - SCOPUS:84864917023
SN - 0902-0063
VL - 26
SP - 615
EP - 621
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 4
ER -