Michael M Maher MD, Presenter: Nothing to Disclose

Victorine Muse, Abstract Co-Author: Nothing to Disclose

Mannudeep K. Kalra MD, Abstract Co-Author: Nothing to Disclose

Conrad Wittram MBChB, Abstract Co-Author: Nothing to Disclose

Jo-Anne O'Malley Shepard MD, Abstract Co-Author: Nothing to Disclose

To establish incidence of hemoptysis at PNB of thorax in a high-volume practice and to analyze factors associated with its occurrence.

A radiology database was searched for patients who underwent PNB complicated by hemoptysis. The study period was 1/1998-4/2004. The number of PNB complicated by hemoptysis was recorded and compared to a similar number of randomly chosen patients who did not suffer hemoptysis. Electronic medical records and complication data pertaining to PNB were reviewed for the two groups of patients. Patient demographics, inpatient/outpatient status, coagulation parameters, size and location of lung mass, nature of lesion (solid vs cavitated, having airway running through), proximity to pulmonary vessels, presence of parenchymal hemorrhage on CT and pathologic diagnoses were recorded. Data analysis was performed using appropriate statistical tests.

Of 1408 PNB procedures performed, there were 30 cases (2.1%) of hemoptysis, all of which were self-limited. There was no difference between the hemoptysis and control groups for age or male/female ratio (69±2 vs 65±2 years; 20/10 vs 14/16; p=NS). Coagulation parameters prior to biopsy were normal in both groups. The number of inpatients at the time of biopsy was significantly higher in the hemoptysis group versus control group (12 vs 5 patients, p<0.05). There was no significant difference in size (2.7±0.3 vs 2.3±0.3 cm) or nature of lesion or proximity of lesion to vessels (p=NS). The anatomic location of lesions was significantly different with more lesions located in the lower lobes in hemoptysis group compared to control group (p<0.05). Patients who developed hemoptysis had higher incidence of hemorrhage on CT (post PNB) than control group (22 vs 17 patients; p=NS). There was no difference in pathological diagnosis between the two groups but the incidence of non-diagnostic specimens was significantly higher in the hemoptysis group (10 vs 2; p<0.05)

Hemoptysis, a rare complication following PNB, is more commonly associated with inpatient status, and lower lobe lesion location. Biopsies complicated by hemoptysis are more likely to be non-diagnostic.

Maher, M, Muse, V, Kalra, M, Wittram, C, Shepard, J, Incidence of Hemoptysis Following Percutaneous Needle Biopsy of the Thorax: A 6-year Study of 1408 Consecutive Cases.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4407309.html