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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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Abstract

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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Acknowledgments

D.P.K. is the Frances King Black Endowed Professorship for Cancer Research.

This research is supported, in part, by the National Institutes of Health through MD Anderson’s Cancer Center Support Grant CA016672.

Conflicts of interest

All authors report no conflicts.

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Authors and Affiliations

  1. Department of Infectious Diseases, Infection Control and Employee Health, Unit 1463, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA

    S. P. Georgiadou, F. L. Sampsonas, J. M. Granger & D. P. Kontoyiannis

  2. Department of Thoracic and Cardiovascular Surgery, Unit 1489, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA

    D. Rice & S. Swisher

Authors
  1. S. P. Georgiadou
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  2. F. L. Sampsonas
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  3. D. Rice
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  4. J. M. Granger
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  5. S. Swisher
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  6. D. P. Kontoyiannis
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Correspondence to D. P. Kontoyiannis.

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Georgiadou, S.P., Sampsonas, F.L., Rice, D. et al. 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. Eur J Clin Microbiol Infect Dis 32, 101–105 (2013). https://doi.org/10.1007/s10096-012-1720-9

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  • DOI: https://doi.org/10.1007/s10096-012-1720-9

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