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June 12, 1967

Transthoracic Needle Biopsy

Author Affiliations

Los Angeles

JAMA. 1967;200(11):1003. doi:10.1001/jama.1967.03120240131043

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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myocardial infarct became cold, sweaty, and severely hypotensive about five minutes after the biopsy needle had been withdrawn.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