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Vol. 15. Issue 4.
Pages 589-595 (July - August 2009)
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Vol. 15. Issue 4.
Pages 589-595 (July - August 2009)
Artigo Original/Original Article
Open Access
Biópsia transtorácica com agulha cortante (Trucut) para o diagnóstico dos tumores mediastínicos
Transthoracic biopsy with core cutting needle (Trucut) for the diagnosis of mediastinal tumors
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Mauro Zamboni1,
Corresponding author
mauro.zamboni@gmail.com

Correspondência/Correspondence to: Mauro Zamboni Rua Sorocaba 464/302 – CEP 22271-110 – Rio de Janeiro – RJ – Brasil.
, Deborah C. Lannes2, Paulo de Biasi Cordeiro3, Edson Toscano4, Emanuel B. Torquato4, Samuel S. de Biasi Cordeiro4, Aureliano Cavalcanti5
1 TE SBPT – Pneumologista do Grupo de Oncologia Torácica do HC I – INCA/MS/TE SBPT – Pulmonologist, Thoracic Oncology Group, HC I – INCA/MS
2 Pneumologista do Grupo de Oncologia Torácica do HC I – INCA/MS/Pulmonologist, Thoracic Oncology Group HC I – INCA/MS
3 TE SBCT – Cirurgião torácico – Director do HC I – INCA/MS/TE SBCT – Thoracic Surgeon, Head, HC I – INCA/MS
4 TE SBCT – Cirurgiões torácicos do HC I – INCA/MS/TE SBCT – Thoracic Surgeons, HC I – INCA/MS
5 TE SBCT – Cirurgião torácico – Chefe do Serviço de Cirurgia Torácica – HC I – INCA/MS/TE SBCT – Thoracic Surgeon, Head, Thoracic Surgery Unit, HC I – INCA/MS
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Objetivo: Determinar a contribuição da biópsia percutânea com agulha cortante (Trucut) no diagnóstico das massas mediastínicas. Método: Revisão retrospectiva de 56 doentes com massas mediastínicas submetidos a biópsias com agulha cortante orientadas, mas não guiadas, pela tomografia computadorizada do tórax, no período de 1999 a 2008. Resultados: A biópsia percutânea com agulha cortante forneceu material adequado para o diagnóstico em 49/56 casos, com índice de positividade de 88%. Em 7/56, o material colhido foi insuficiente para definir o diagnóstico (12%). Este método foi capaz de definir o diagnóstico em 88% dos doentes: 23/56 (41%) linfomas; 12/56 (21%) timomas; 5/56 (3%) carcinomas tímicos; 3/56 (2%) carcinoma indiferenciado de pequenas células e 1/56 (0,6%) adenocarcinoma metastático, carcinoma epidermóide metastático, carcinoma neuroendócrino primitivo, plasmocitoma, teratoma, bócio. Após a biópsia, os doentes foram submetidos a radiografia do tórax. Não houve nenhum tipo de complicação nestes doentes. Conclusão: A biópsia transtorácica com agulha cortante (Trucut) orientada, mas não guiada pela tomografia computadorizada, tem alto rendimento, esclrrecendo o diagnóstico na maioria dos portadores de massas mediastínicas e pode ser útil, evitando a toracotomia exploradora, nos casos de tumores do mediastino inoperáveis ou de tratamento quimioterápico.

Rev Port Pneumol 2009; XV (4): 589-595

Palavras-chave:
Biópsia por agulha
biópsia com agulha Trucut
neoplasias do mediastino
mediastino/ /lesões
Abstract

Aim: To determine the contribution of percutaneous biopsy with core cutting needle (Trucut) in the diagnosis of mediastinal tumours. Method: Retrospective review of 56 patients with mediastinal lesions who underwent percutaneous core cutting needle biopsy, oriented but not guided by computer assisted tomography of the thorax, 1999 – 2008. Results: Percutaneous biopsy with core cutting needle provided adequate material in 49/56, with a total positive sample rate of 88%. In 7/56 (12%) cases the material was insufficient to define the diagnosis. Percutaneous core cutting needle biopsy established a specific histological diagnosis in 88% of the patients: 23/56 (41%) lymphomas; 12/56 (21%) thymomas; 5/56 (3%) thymic carcinomas; 3/56 (2%) small cell carcinoma and 1/56 (0.6%) metastatic adenocarcinoma, metastatic squamous cell carcinoma, neuroendocrine primitive carcinoma, plasmocytoma, teratoma and goiter. All patients underwent thoracic X-ray after the procedure. No complications were found in these patients. Conclusion: Percutaneous core cutting needle biopsy (Trucut) oriented but not guided by computer assisted tomography of the thorax is an easy and safe procedure which can provide a precise diagnosis in the majority of mediastinal tumours and can prevent the need for exploratory thoracic surgery in cases which are medically treatable or non-resectable.

Rev Port Pneumol 2009; XV (4): 589-595

Key-words:
Biopsy
needle
Trucut needle biopsy
mediastinal/lesions
mediastinal neoplasms
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Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
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