Abstract

Introduction: Pathological confirmation of a newly identified tumour is needed for choosing the adequate treatment. Patients may have a low performance status which makes them unsuitable for invasive diagnostic procedures. Percutaneous transthoracic biopsy is a minimally invasive method which can provide tissue samples for identification of lung or mediastinal tumours.

Material and method: Data from consecutive patients which underwent fluoroscopic-guided transthoracic puncture-biopsy (FGTPB) in a tertiary cancer center from Republic of Moldova from 2019 to 2021 were retrospectively collected.

Results: We identified 54 patients with lung tumors and 12 patients with mediastinal tumours. In the lung tumors group, median age was 57 years and in the mediastinal tumours group the median age was 27.5 years. Most of the lung tumors were situated in the superior lobes (79.6%) and had less than 5 cm (70.4%). The majority of mediastinal tumors were situated anteriorly (66.7%) and had more than 10 cm (58.3%). The sensitivity of transthoracic percutaneous biopsy was 79.6% in lung tumours and 83.3% in mediastinal tumours, identifying malignant or infectious pathology, or fibrosis. Lung biopsy had a low rate of pneumothorax (5.6%) and of bleeding (3.7%). Mediastinal tumor biopsy had a rate of pneumothorax of 16.7%.

Conclusion: Transthoracic puncture-biopsy made under fluoroscopic guidance is a safe and efficient alternative diagnostic procedure for unfit patients with lung or mediastinal tumours.