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What to do with the patient who shows a pulmonary mass but in whom the usual diagnostic procedures are not particularly helpful? Dr. Dahlgren, a pathologist, and Dr. Nordenstrom, a radiologist, both at the Karolinska Institute, describe the way they avoid any diagnostic impasse by proceeding directly from the stage of negative findings to a needle biopsy. Using a special table and television fluoroscopy, they obtained a satisfactory specimen in 74% of 519 biopsies from 365 cases. Microscopy gave a definitive diagnosis in 316 (87%) of these 365 patients.
Regarding complications, the authors state that with a single exception, no signs of air embolism, shock, or other alarming symptoms were noted. In the one exception, a 70-year-old man with a prior myocardial infarct became cold, sweaty, and severely hypotensive about five minutes after the biopsy needle had been withdrawn. The electrocardiogram and transaminase studies indicated that the episode was due
Armstrong BW. Transthoracic Needle Biopsy. JAMA. 1967;200(11):1003. doi:10.1001/jama.1967.03120240131043
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