Ultrathin Needle Aspiration of the Lung in Infectious and Malignant Disease1–3

Fifty patients with either malignant (n = 25) or infectious/inflammatory (n = 25) chest lesions had lung aspirations using ultrathin needles, 24 to 25 gauge. The procedure's overall sensitivity was 87%, and the specificity was 100%. The diagnostic yield was 90% (9/10) from peripheral malignant coin lesions, 100% (3/3) from malignant cavities, and 42% (5/12) from infected, nonmalignant cavities. Antimicrobial therapy probably contributed to poor microbiologic results in the latter group. Twenty-two of the patients previously had flexible fiberoptic bronchoscopy with negative results. In this select group, a diagnosis was established in 45% (10/22): 7 had malignant lesions, 2 had anaerobic lung abscesses, and 1 had histoplasmosis. In patients with infectious diseases, a variety of bacterial, mycobacterial, and fungal infections were confirmed including the diagnosis of Legionella pneumophila in 2 patients. A definitive diagnosis was obtained in 6 of 8 immunosuppressed patients who presented with indetermina...