Transthoracic biopsy under the control of computed tomography as a method of differential diagnosis of nodular neoplasms of the lung in outpatient settings: Retrospective cohort study

Background. Morphological verification of central and peripheral focal lung neoplasms is a difficult task for modern minimally invasive methods of differential diagnosis. The use of transthoracic trepanobiopsy of lung neoplasms under the control of computed tomography (CT) allows you to obtain informative, histological material and make a correct diagnosis.

Aim. The aim of the study was to determine the possibility and safety of performing transthoracic trepanobiopsy of lung tumors under the control of CT in patients who are on an outpatient appointment in a third-level institution in order to obtain informative histological material.

Materials and methods. From January 2020 to April 2021, 65 patients underwent transthoracic trepanobiopsy of focal lung neoplasms under the control of CT on an outpatient basis in the polyclinic department of the Ostroverkhov Kursk Cancer Research and Clinical Center.

Results. The average time spent on performing a biopsy, with preliminary marking under CT control, was 15.1±4.5 minutes. In 2 (3.1%) cases, the morphological material was uninformative. The informativeness of the performed trepanobiopsies for the verification of the lung tumor process was 96.9%. Complications were observed in 5 (7.6%) patients: pneumothorax – in 4 (6.1%), hemoptysis – in 1 (1.5%). Pneumothorax occurred mainly in patients aged 55–67 years.

Conclusion. The used method of transthoracic lung trepanobiopsy under CT control should be used in outpatient settings of third-level institutions for morphological confirmation of the diagnosis, since it is safe and highly informative for patients, which is confirmed by a low percentage of complications (7.6%) and allows for differential diagnosis of focal lung neoplasms at the pre-hospital stage.