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A Rare Complication of a CT-Guided Biopsy

      CASE SUMMARY

      A 68-year-old gentleman presented with severe abdominal discomfort which led to the incidental finding of a right upper lobe mass. A positron emission tomography/computed tomography (CT) was then performed which demonstrated increased metabolic activity limited to the peripheral mass. A CT-guided biopsy (see Figure 1) was performed with the pathology consistent with a poorly differentiated non-small cell lung cancer. The tumor increased in size from 2.3 × 1.9 cm on the CT-guided biopsy scan only 5 weeks later. A repeat diagnostic CT with contrast was recommended and performed now demonstrating the mass to be 8.8 × 5.9 cm. As seen in Figure 2, there is direct extension of the tumor outside the chest wall in the exact tract of the needle (see Figure 1). This is a rare complication for patients with lung cancer,
      • Sawabata N
      • Ohta M
      • Maeda H
      Fine-needle aspiration cytologic technique for lung cancer has a high potential of malignant cell spread through the tract.
      which is more commonly seen in aggressive malignancies.
      Figure thumbnail gr1
      FIGURE 1Axial computed tomography obtained in preparation for biopsy with the needle on the chest wall.
      Figure thumbnail gr2
      FIGURE 2Contrast enhanced computed tomography (CT) scan 2 months after the initial CT scan demonstrating tumor tracking along the biopsy tract.

      REFERENCE

        • Sawabata N
        • Ohta M
        • Maeda H
        Fine-needle aspiration cytologic technique for lung cancer has a high potential of malignant cell spread through the tract.
        Chest. 2000; 118: 936-939