When the transthoracic needle biopsy of the breast or mediastinal structures, a cutting needle is used to draw a cylinder of tissue for histological analysis. Indications transthoracic needle biopsy is performed to investigate peripheral lung nodules or masses hilar, mediastinal and pleural diseases undiagnosed infiltrates or pneumonia if bronchoscopy is contraindicated or is not diagnostic, if it is performed under CT guidance and by an experienced cytopathologists, transthoracic needle biopsy can confirm the diagnosis of cancer with an accuracy of> 95%. The needle biopsy, however, only provides an accurate diagnosis of 50-60% of the time for benign processes. Contraindications The contraindications are the same as for Pleurapunktionen. Other contraindications include the following: Mechanical ventilation contralateral pneumonectomy suspected vascular lesions purulent lung abscess hydatid cyst Pulmonary hypertension Bullous lung disease intractable cough bleeding disorder or anticoagulation, which can not be corrected and platelet counts <50,000 / uV Procedure The transthoracic needle biopsy is interventional usually by a radiologists performed often together with a cytopathologists. Under sterile conditions, local anesthesia and imaging techniques - usually CT but sometimes sonography in pleuralbasierten lesions - a biopsy needle is guided into the suspected lesion while patients hold their breath. The lesions are aspirated with or without salt solution. Two or three samples are collected for cytological and bacteriological processing. After the procedure done fluoroscopy and chest X-ray to rule out pneumothorax and bleeding. Hollow needle biopsies are used to obtain a "cylinder of tissue" for histological examination. Complications Complications include pneumothorax (10 to 37%) hemoptysis (10 to 25%) Parenchymal bleeding air embolism subcutaneous emphysema


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