S�PER�OR SULKUS T�M�RLER�NDE ULTRASONOGRAF� REHBERL���NDE YAPILAN TRANSTORAS�K ��NE ASP�RASYONUNUN TANISAL DE�ER�

�ENER C�MERT, Sevda; �A�LAYAN, Benan; SALEP��, Banu; F�DAN, Ali; TORUN PARMAKSIZ, Elif

Cilt : 37 Say� : 3 Y�l : 2023

37/3Son Say� Erken Bask� Ar�iv Pop�ler Makaleler

Yazar Katk� Formu

S�PER�OR SULKUS T�M�RLER�NDE ULTRASONOGRAF� REHBERL��NDE YAPILAN TRANSTORAS�K ��NE ASP�RASYONUNUN TANISAL DE�ER� [G��s Hastanesi Dergisi]

G��s Hastanesi Dergisi. 2013; 27(1): 41-48

S�PER�OR SULKUS T�M�RLER�NDE ULTRASONOGRAF� REHBERL��NDE YAPILAN TRANSTORAS�K ��NE ASP�RASYONUNUN TANISAL DE�ER�

Sevda �ENER C�MERT¹, Benan �A�LAYAN¹, Banu SALEP��¹, Ali F�DAN¹, Elif TORUN PARMAKSIZ¹
Dr. L�tfi K�rdar Kartal E�itim ve Ara�t�rma Hastanesi, G��s Hastal�klar�, �stanbul, T�rkiye

�al��mam�zda s�perior sulkus t�m�rlerinde, ultrasonografi rehberli�inde yap�lan transtorasik i�ne aspirasyonunun (TT�A) tan� koymadaki ba�ar� oran�n� saptamay� ama�lad�k. Ocak 2009 - Mart 2012 tarihleri aras�nda hastanemiz G��s Hastal�klar� Klini�i'nde tetkik edilen, akci�er grafisi veya bilgisayarl� toraks tomografisine g�re s�perior sulkus t�m�r� �n tan�s� olan ve transtorasik ultrasonografi rehberli�inde TT�A yap�lan olgular �al��maya al�nd�. �al��maya 17 (%89.5)'si erkek, 2 (%10.5)'si kad�n; ya� ortalamalar� 56.4�8.0 (min:38; max:71) y�l olan toplam 19 olgu dahil edildi. T�m�rlerin 6 (%31.6)'s� sol, 13 (%68.4)'� ise sa� hemitoraksta yer al�yordu. Ultrasonografi rehberli�inde TT�A 10 (%52.6) olguda s�rttan apikal yakla��mla, 9 (%47.4) olguda ise supraklavikular yakla��mla yap�ld�. On alt� olguda i�lem tan�sal olurken, 2 olguda tan� konulamad�. Bir olgu ise n�roendokrin t�m�r tan�s� ald�. Ancak n�roendokrin t�m�rler �ok heterojen bir t�m�r grubu oldu�u ve doku incelemesi gerektirdi�i i�in bu olgu i�lemin tan�sal olmad�� gruba al�nd�. Ultrasonografi rehberli�inde TT�A ile tan� konulamayan 2 olguya ise bilgisayarl� toraks tomografisi rehberli�inde tru-cut biyopsi ile doku �rne�i al�narak k��k h�creli d�� akci�er kanseri tan�s� konuldu. S�perior sulkus t�m�rlerine ultrasonografi rehberli�inde TT�A ile tan� koyma oran�m�z %84.2 olarak hesapland�. Ultrasonografi hasta ba��nda kolay uygulanabilen, radyasyon maruziyeti olmayan, ucuz, tekrarlanabilir ve g�venli bir g�r�nt�leme y�ntemidir. S�perior sulkus t�m�rlerinde ultrasonografi rehberli�inde tan� koyma oran� y�ksektir. Bu nedenle, bilgisayarl� tomografi rehberli�inde al�nan biyopsiye alternatif olarak uygulanabilir.

Anahtar Kelimeler: S�perior sulkus t�m�r�, toraks ultrasonografisi, i�ne aspirasyon biyopsisi, tan� y�ntemi

THE DIAGNOSTIC VALUE OF ULTRASOUND GUIDED TRANSTHORACIC NEEDLE ASPIRATION IN SUPERIOR SULCUS TUMORS

The aim of this study was to determine the success rate of ultrasound-guided transthoracic needle aspiration (TTNA) in the diagnosis of superior sulcus tumors. The patients examined between January 2009- March 2012 at the Department of Pulmonary Diseases, with the pre-diagnosis of superior sulcus tumors based on chest radiography or computed tomography and whose transthoracic ultrasonography guided TTNA was performed, were included in the study. Seventeen (89.5%) male, 2 (10.5%) female totally 19 cases with the mean age of 56.4 � 8.0 (min: 38, max: 71) years were included. Six (31.6%) of the superior sulcus tumors were at the left hemithorax, 13 (68.4%) of them were at the right hemithorax. Ultrasound guided TTNA was performed by the apical approach from the backside in 10 (52.6%) cases and by supraclavicular approach in 9 (47.4%) cases. While the procedure was diagnostic in 16 cases, it was nondiagnostic in 2 cases. One case is diagnosed as neuroendocrine tumor. However, neuroendocrine tumors are a very heterogeneous group of tumors and tissue analysis is required, this case was included in nondiagnostic group. Two cases whose the ultrasound guided TTNA was nondiagnostic, were diagnosed as non-small cell lung cancer by taking a sample of tissue with trucut biopsy guided by computed tomography. The diagnostic rate of with ultrasound guided TTNA in superior sulcus tumors was calculated as 84.2%. Ultrasonography is a safe, cheap and repeatable imaging method without radiation exposure which can be performed easily at the bedside. The rate of diagnosis is high by tissue sampling with the guidance of ultrasound in superior sulcus tumors. Therefore, it can be applied as an alternative to biopsy guided by computed tomography.

Keywords: superior sulcus tumors, thorax ultrasonography, needle aspiration biopsy, diagnostic method

Makale Dili: T�rk�e

ATIF KOPYALA

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S�PER�OR SULKUS T�M�RLER�NDE ULTRASONOGRAF� REHBERL���NDE YAPILAN TRANSTORAS�K ��NE ASP�RASYONUNUN TANISAL DE�ER�

THE DIAGNOSTIC VALUE OF ULTRASOUND GUIDED TRANSTHORACIC NEEDLE ASPIRATION IN SUPERIOR SULCUS TUMORS

S�PER�OR SULKUS T�M�RLER�NDE ULTRASONOGRAF� REHBERL��NDE YAPILAN TRANSTORAS�K ��NE ASP�RASYONUNUN TANISAL DE�ER�