A comparison of biopsy through a parasternal anterior mediastinotomy under local anesthesia and percutaneous needle biopsy for malignant anterior mediastinal tumors
Masazumi Watanabe, Keigo Takagi, Teruhiro Aoki, Yuichi Ozeki, Susumu Tanaka, Hideo Kobayashi, Shinsuke Aida
The various methods of treating the numerous types of anterior mediastinal neoplasms are undergoing refinements; however, prior to the commencement of any treatment, an accurate histologic diagnosis must be established. We conducted a retrospective analysis of biopsies performed through a parasternal anterior mediastinotomy (PAM) on 21 patients with an anterior mediastial mass suspected of being malignant by computed tomography (CT) and other clinical information. Patients with possible localized thymomas were excluded. Mediastinotomy, which enables relatively large tissue samples to be taken, was performed through the bed of the second or third costal cartilage under local anesthesia. In 19 of the 21 patients (90%), the histologic diagnosis made from the mediastinotomy biopsy was identical to the final diagnosis. Conversely, although the tissue obtained from needle biopsy was sufficient for a histologic diagnosis in 11 of 12 patients, the histologic diagnosis made from the needle biopsy was the same as the final diagnosis in only 5 of 10 patients (50%). Thus, diagnostic accuracy was significantly higher in the mediastinotomy biopsies than in the needle biopsies (P = 0.0318). Moreover, the mediastinotomy biopsy specimens revealed subtypes of lymphomas and germ cell tumors. All of the patients from whom a mediastinotomy biopsy had been taken began appropriate therapy without delay according to the histologic diagnosis. These results suggest that the PAM approach should be chosen as the preferred method of biopsy for suspected malignant anterior mediastinal tumors.
Surgery today
Anterior mediastinal tumor
Anterior mediastinotomy
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Needle Biopsy Medicine & Life Sciences
Local Anesthesia Medicine & Life Sciences
Biopsy Medicine & Life Sciences
Mediastinal Neoplasms Medicine & Life Sciences
Costal Cartilage Medicine & Life Sciences
Thymoma Medicine & Life Sciences
Germ Cell and Embryonal Neoplasms Medicine & Life Sciences
Watanabe, M., Takagi, K., Aoki, T., Ozeki, Y., Tanaka, S., Kobayashi, H., & Aida, S. (1998). A comparison of biopsy through a parasternal anterior mediastinotomy under local anesthesia and percutaneous needle biopsy for malignant anterior mediastinal tumors. Surgery today, 28(10), 1022-1026. https://doi.org/10.1007/BF02483955
A comparison of biopsy through a parasternal anterior mediastinotomy under local anesthesia and percutaneous needle biopsy for malignant anterior mediastinal tumors. / Watanabe, Masazumi; Takagi, Keigo; Aoki, Teruhiro; Ozeki, Yuichi; Tanaka, Susumu; Kobayashi, Hideo; Aida, Shinsuke.
In: Surgery today, Vol. 28, No. 10, 01.01.1998, p. 1022-1026.
Watanabe, M, Takagi, K, Aoki, T, Ozeki, Y, Tanaka, S, Kobayashi, H & Aida, S 1998, 'A comparison of biopsy through a parasternal anterior mediastinotomy under local anesthesia and percutaneous needle biopsy for malignant anterior mediastinal tumors', Surgery today, vol. 28, no. 10, pp. 1022-1026. https://doi.org/10.1007/BF02483955
Watanabe M, Takagi K, Aoki T, Ozeki Y, Tanaka S, Kobayashi H et al. A comparison of biopsy through a parasternal anterior mediastinotomy under local anesthesia and percutaneous needle biopsy for malignant anterior mediastinal tumors. Surgery today. 1998 Jan 1;28(10):1022-1026. https://doi.org/10.1007/BF02483955
Watanabe, Masazumi ; Takagi, Keigo ; Aoki, Teruhiro ; Ozeki, Yuichi ; Tanaka, Susumu ; Kobayashi, Hideo ; Aida, Shinsuke. / A comparison of biopsy through a parasternal anterior mediastinotomy under local anesthesia and percutaneous needle biopsy for malignant anterior mediastinal tumors. In: Surgery today. 1998 ; Vol. 28, No. 10. pp. 1022-1026.
@article{0817125100064259a483de4e3565d216,
title = "A comparison of biopsy through a parasternal anterior mediastinotomy under local anesthesia and percutaneous needle biopsy for malignant anterior mediastinal tumors",
abstract = "The various methods of treating the numerous types of anterior mediastinal neoplasms are undergoing refinements; however, prior to the commencement of any treatment, an accurate histologic diagnosis must be established. We conducted a retrospective analysis of biopsies performed through a parasternal anterior mediastinotomy (PAM) on 21 patients with an anterior mediastial mass suspected of being malignant by computed tomography (CT) and other clinical information. Patients with possible localized thymomas were excluded. Mediastinotomy, which enables relatively large tissue samples to be taken, was performed through the bed of the second or third costal cartilage under local anesthesia. In 19 of the 21 patients (90%), the histologic diagnosis made from the mediastinotomy biopsy was identical to the final diagnosis. Conversely, although the tissue obtained from needle biopsy was sufficient for a histologic diagnosis in 11 of 12 patients, the histologic diagnosis made from the needle biopsy was the same as the final diagnosis in only 5 of 10 patients (50%). Thus, diagnostic accuracy was significantly higher in the mediastinotomy biopsies than in the needle biopsies (P = 0.0318). Moreover, the mediastinotomy biopsy specimens revealed subtypes of lymphomas and germ cell tumors. All of the patients from whom a mediastinotomy biopsy had been taken began appropriate therapy without delay according to the histologic diagnosis. These results suggest that the PAM approach should be chosen as the preferred method of biopsy for suspected malignant anterior mediastinal tumors.",
keywords = "Anterior mediastinal tumor, Anterior mediastinotomy, Biopsy",
author = "Masazumi Watanabe and Keigo Takagi and Teruhiro Aoki and Yuichi Ozeki and Susumu Tanaka and Hideo Kobayashi and Shinsuke Aida",
doi = "10.1007/BF02483955",
journal = "Surgery Today",
publisher = "Springer Japan",
T1 - A comparison of biopsy through a parasternal anterior mediastinotomy under local anesthesia and percutaneous needle biopsy for malignant anterior mediastinal tumors
AU - Watanabe, Masazumi
AU - Takagi, Keigo
AU - Aoki, Teruhiro
AU - Ozeki, Yuichi
AU - Tanaka, Susumu
AU - Kobayashi, Hideo
AU - Aida, Shinsuke
N2 - The various methods of treating the numerous types of anterior mediastinal neoplasms are undergoing refinements; however, prior to the commencement of any treatment, an accurate histologic diagnosis must be established. We conducted a retrospective analysis of biopsies performed through a parasternal anterior mediastinotomy (PAM) on 21 patients with an anterior mediastial mass suspected of being malignant by computed tomography (CT) and other clinical information. Patients with possible localized thymomas were excluded. Mediastinotomy, which enables relatively large tissue samples to be taken, was performed through the bed of the second or third costal cartilage under local anesthesia. In 19 of the 21 patients (90%), the histologic diagnosis made from the mediastinotomy biopsy was identical to the final diagnosis. Conversely, although the tissue obtained from needle biopsy was sufficient for a histologic diagnosis in 11 of 12 patients, the histologic diagnosis made from the needle biopsy was the same as the final diagnosis in only 5 of 10 patients (50%). Thus, diagnostic accuracy was significantly higher in the mediastinotomy biopsies than in the needle biopsies (P = 0.0318). Moreover, the mediastinotomy biopsy specimens revealed subtypes of lymphomas and germ cell tumors. All of the patients from whom a mediastinotomy biopsy had been taken began appropriate therapy without delay according to the histologic diagnosis. These results suggest that the PAM approach should be chosen as the preferred method of biopsy for suspected malignant anterior mediastinal tumors.
AB - The various methods of treating the numerous types of anterior mediastinal neoplasms are undergoing refinements; however, prior to the commencement of any treatment, an accurate histologic diagnosis must be established. We conducted a retrospective analysis of biopsies performed through a parasternal anterior mediastinotomy (PAM) on 21 patients with an anterior mediastial mass suspected of being malignant by computed tomography (CT) and other clinical information. Patients with possible localized thymomas were excluded. Mediastinotomy, which enables relatively large tissue samples to be taken, was performed through the bed of the second or third costal cartilage under local anesthesia. In 19 of the 21 patients (90%), the histologic diagnosis made from the mediastinotomy biopsy was identical to the final diagnosis. Conversely, although the tissue obtained from needle biopsy was sufficient for a histologic diagnosis in 11 of 12 patients, the histologic diagnosis made from the needle biopsy was the same as the final diagnosis in only 5 of 10 patients (50%). Thus, diagnostic accuracy was significantly higher in the mediastinotomy biopsies than in the needle biopsies (P = 0.0318). Moreover, the mediastinotomy biopsy specimens revealed subtypes of lymphomas and germ cell tumors. All of the patients from whom a mediastinotomy biopsy had been taken began appropriate therapy without delay according to the histologic diagnosis. These results suggest that the PAM approach should be chosen as the preferred method of biopsy for suspected malignant anterior mediastinal tumors.
KW - Anterior mediastinal tumor
KW - Anterior mediastinotomy
KW - Biopsy
U2 - 10.1007/BF02483955
DO - 10.1007/BF02483955
JO - Surgery Today
JF - Surgery Today