Open-lung biopsy in patients with undiagnosed lung lesions referred at a tertiary cancer center is safe and reveals noncancerous, noninfectious entities as the most common diagnoses.
Open-lung biopsy in patients with undiagnosed lung lesions referred at a tertiary cancer center is safe and reveals noncancerous, noninfectious entities as the most common diagnoses.
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DOI：
10.1007/s10096-012-1720-9
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发表时间：
2013-01
影响因子：
4.5
通讯作者：
Kontoyiannis, D. P.
中科院分区：
文献类型：
--
作者：
Georgiadou, S. P.;Sampsonas, F. L.;Rice, D.;Granger, J. M.;Swisher, S.;Kontoyiannis, D. P.
我们评估了大型三级癌症中心开胸肺活检(OLB)的诊断效率，以确定感染性疾病作为未诊断肺部病变的原因所起的作用。所有连续的患有单发或多发肺结节或肿块的成人患者在10年内(1998-2007年)接受了诊断性OLP检查。对其恶变危险因素、临床和放射学特点进行回顾，并对其术后并发症进行评估。我们评估了155名患者，中位年龄为57岁(范围为19-83岁)。我们确定了29名患者(19%)的感染病因。本组最常见的诊断是组织胞浆菌病(12例(41%))，其次是非结核分支杆菌感染(7例[24%])和曲霉菌病(4例[14%])。在剩余的126名患者中，大多数人被诊断为非恶性，最常见的是非特异性肉芽肿(26%)，而只有17%的人被诊断为恶性。我们观察到最终诊断为感染性、恶性或非感染性和非恶性的患者在人口学、实验室和临床特征上没有显著差异。6%的患者至少有一次术后并发症，术后死亡率为1%。OLP是一种安全的诊断程序，它经常识别各种感染性和炎症性疾病。
We evaluated the diagnostic yield of open-lung biopsies (OLBs) in a large tertiary cancer center to determine the role of infectious diseases as causes of undiagnosed pulmonary lesions. All consecutive adult patients with either single or multiple pulmonary nodules or masses who underwent a diagnostic OLB over a period of 10 years (1998–2007) were retrospectively identified. Their risk factors for malignancy and clinical and radiological characteristics were reviewed, and their postoperative complications were assessed. We evaluated 155 patients with a median age of 57 years (range, 19–83 years). We identified infectious etiologies in 29 patients (19 %). The most common diagnosis in this group was histoplasmosis (12 [41 %]), followed by nontuberculous mycobacterial infection (7 [24 %]) and aspergillosis (4 [14 %]). The majority of the 126 remaining patients had nonmalignant diagnoses, the most prevalent being nonspecific granuloma (26 %), whereas only 17 % had malignant diagnoses. We observed no significant differences among the patients with infectious, malignant, or both noninfectious and nonmalignant final diagnoses regarding their demographic, laboratory, and clinical characteristics. Six percent of the patients had at least one post-OLB complication, and the post-OLB mortality rate was 1 %. OLB is a safe diagnostic procedure which frequently identifies a wide variety of infectious and inflammatory diseases.
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影响因子：
158.5
作者：
Ost, D;Fein, AM;Feinsilver, SH
通讯作者：
Feinsilver, SH
影响因子：
9.6
作者：
Wahidi, Momen M.;Govert, Joseph A.;McCrory, Douglas C.
通讯作者：
McCrory, Douglas C.
影响因子：
4.6
作者：
Smith, MA;Battafarano, RJ;Benfield, JR
通讯作者：
Benfield, JR
影响因子：
--
作者：
Swensen, SJ;Silverstein, MD;Edell, ES
通讯作者：
Edell, ES
影响因子：
3.6
作者：
Kothary, Nishita;Bartos, Jason A.;Hofmann, Lawrence V.
通讯作者：
Hofmann, Lawrence V.