Biopsia de tumores mediastinales con aguja gruesa transtorácica guiada por ecografía

Introduction: Ultrasound-guided biopsy diagnosis of mediastinal lesions is a complex procedure, and few publications about the topic are available both nationally and internationally. Objective: Evaluate the diagnostic value and complications of ultrasound-guided transthoracic core needle biopsy in patients with mediastinal lesions. Methods: An observational retrospective study was conducted of patients with ultrasound-visible mediastinal tumors attending Hermanos Ameijeiras Hospital from January 2016 to December 2018 (n = 56). Statistical analysis was performed with SPSS version 20.0. The chi square test was used to compare associations of variables. A 0.05 significance level was adopted. Evaluation was carried out of the effectiveness of the procedure and the number and seriousness of the complications. Results: Ultrasound-guided core needle biopsy was useful for diagnosis in 98.2% of the mediastinal mass samples, in contrast with 37.5% for fine-needle aspiration. A predominance was found of malignant lesion diagnoses, with lymphomas as the most frequent (41.1%). The diagnostic value of ultrasound to detect malignant lesions was expressed in the following terms: sensitivity 89%, specificity 56%, positive predictive value 91.3%, negative predictive value 50% and accuracy index 83.9%. Complications were mild, with an index of 7.1%. Conclusions: The study is the first published national report about the use of ultrasound-guided core needle biopsy, showing its effectiveness and safety, as well as its low cost in comparison with other techniques. Key words: mediastinal mass; ultrasound; core needle biopsy.