Anterior mediastinal lesions: transsternal biopsy with CT guidance. Work in progress.

Abstract

To assess the technique, results, and patient tolerance of transsternal biopsy of anterior mediastinal lesions under computed tomographic (CT) guidance. Seven patients (four women and three men) with anterior mediastinal lesions underwent eight transsternal biopsies. Patients were included in the study if there was a risk of injury to internal mammary vessels or a danger of tranversing the lung by the biopsy needle. Patients were specifically questioned about the pain caused by the transsternal needle. A pain scale was not used. Conscious sedation and local anesthesia requirements provided gross evaluation of the patients' tolerance to the procedure. CT scans were used to guide and confirm optimal alignment of the transsternal needle with the lesion. Patients experienced minimal discomfort when the sternum was traversed. No instances of pneumothorax, postprocedural pain, or infection were encountered. In six of the seven patients, biopsy specimens were diagnostic. The transsternal approach for biopsy of anterior mediastinal lesions appears safe and is well tolerated.