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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Valorar la rentabilidad de la punci&#243;n aspirativa pulmonar transtor&#225;cica &#40;PAPT&#41; en el diagn&#243;stico del posible carcinoma bronquial subyacente al absceso pulmonar &#40;AP&#41; y conocer la bacteriolog&#237;a del absceso pulmonar secundario a neoplasia &#40;APSN&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Pacientes y m&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Serie consecutiva de 113 AP&#46; En todos se realiz&#243; PAPT bajo control radiol&#243;gico&#44; con aguja 20-22 G&#46; Se realiz&#243; procesamiento microbiol&#243;gico y citol&#243;gico del material obtenido&#46; Se practic&#243; fibrobroncoscopia &#40;FB&#41; si exist&#237;an factores de riesgo de carcinoma pulmonar&#46; Se analizan los casos de APSN y se comparan con el resto de AP&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En 21 AP se encontr&#243; neoplasia asociada&#46; La PAPT fue diagn&#243;stica en 15 casos&#59; hubo dos falsos negativos y en 4 casos no se hizo citolog&#237;a de la muestra&#46; La FB fue diagn&#243;stica en 17 casos&#46; Todas las neoplasias fueron diagnosticadas con alguna de estas 2 t&#233;cnicas&#46; El cultivo de la PAPT fue positivo en el 90&#37; &#40;19&#47;21&#41; de los APSN&#44; siendo <span class="elsevierStyleItalic">H&#46; influenzae</span> la bacteria m&#225;s frecuentemente aislada&#46; Los pacientes con APSN presentaron de forma significativa mayor n&#250;mero de cultivos monomicrobianos &#40;14&#47;19 frente a 33&#47;79&#59; p &#60; 0&#44;02&#41;&#44; mayor participaci&#243;n de bacterias aerobias &#40;19&#47;19 frente a 45&#47;79&#59; p &#60; 0&#44;001&#41; v menor de anaerobias &#40;4&#47;19 frente a 52&#47;79&#59; p &#60; 0&#44;001&#41; que los pacientes con AP primario&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">1&#41;</span> La PAPT posee un alto rendimiento en el diagn&#243;stico bacteriol&#243;gico del APSN y en el del carcinoma asociado&#46; <span class="elsevierStyleItalic">2&#41;</span> La PAPT complementa a la FB en el diagn&#243;stico de la neoplasia subyacente al AP&#44; evitando recurrir a toracotom&#237;as innecesarias&#46; <span class="elsevierStyleItalic">3&#41;</span> En el APSN intervienen una gran variedad de g&#233;rmenes&#44; destacando la participaci&#243;n de bacterias aerobias&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To evaluate the usefulness of transthoraeic needle biopsy &#40;TNB&#41; for the diagnosis of bronchial carcinoma underlying lung abscess &#40;LA&#41;&#44; and to determine the baeteriology of lung abscess secondary to neoplasm &#40;LASN&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">One hundred thirteen consecutive patients diagnosed of LA were enrolled&#46; Radiologically guided TNB was performed on all patients using 20-22 G needles&#46; Microbiological and cytological samples were processed&#46; Fiberoptic bronchoscopy &#40;FB&#41; was performed if there were risk factors for lung cancer&#46; TNB-diagnosed cases were compared with the remaining cases of LA&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Neoplasia was found in 21 LA patients&#46; TNB samples provided diagnostic information in 15 cases&#44; there were 2 false negatives&#44; and no cytology sample was processed in 4 cases&#46; Diagnosis was based on FB in 17 cases&#46; All neoplasias were diagnosed with one technique or the other&#46; TNB culture was positive in 90&#37; &#40;19&#47;21&#41; of the LASN patients&#44; <span class="elsevierStyleItalic">H&#46; influenzae</span> being the most frequently isolated bacterium&#46; The number of cultures that presented a single microbe was significantlv greater &#40;p &#60; 0&#46;02&#41; among LASN patients &#40;14&#47;19 versus 33&#47;79&#41;&#46; These patients also had significantly more aerobic bacteria &#40;19&#47;19 versus 45&#47;79&#59; p &#60; 0&#46;001&#41; and fewer anaerobies &#40;4&#47;19 versus 52&#47;79&#59; p &#60; 0&#46;001&#41; than did the primary LA patients&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">1&#41;</span> TNB is highly useful for arriving at a bacteriologic diagnosis of LASN and in associated cancer&#46; <span class="elsevierStyleItalic">2&#41;</span> TNB complements FB for the diagnosis of neoplasia underlying LA and helps to reduce the number of unnecessary thoracotomies&#46; <span class="elsevierStyleItalic">3&#41;</span> A great variety of germs&#44; particularly aerobic bacteria&#44; are implicated in LASN&#46;</p></span>"
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Journal Information
Vol. 32. Issue 3.
Pages 132-137 (March 1996)
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Vol. 32. Issue 3.
Pages 132-137 (March 1996)
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Utilidad de la punción aspirativa pulmonar transtorácica en el absceso pulmonar secundario a neoplasia
Utility of transthoracic needle biopsy of lung abscess secondary to neoplasia
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A. Vargas Puerto1, N. Peña Griñán, F. Muñoz Lucena, J. Hernández Borge, F. Campos Rodríguez
Sección de Neumología. Hospital Univeristario de Valme. Sevilla
J. Vargas Romero*
* Servicio de Microbiología. Hospital Univeristario de Valme. Sevilla
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Article information
Objetivo

Valorar la rentabilidad de la punción aspirativa pulmonar transtorácica (PAPT) en el diagnóstico del posible carcinoma bronquial subyacente al absceso pulmonar (AP) y conocer la bacteriología del absceso pulmonar secundario a neoplasia (APSN).

Pacientes y método

Serie consecutiva de 113 AP. En todos se realizó PAPT bajo control radiológico, con aguja 20-22 G. Se realizó procesamiento microbiológico y citológico del material obtenido. Se practicó fibrobroncoscopia (FB) si existían factores de riesgo de carcinoma pulmonar. Se analizan los casos de APSN y se comparan con el resto de AP.

Resultados

En 21 AP se encontró neoplasia asociada. La PAPT fue diagnóstica en 15 casos; hubo dos falsos negativos y en 4 casos no se hizo citología de la muestra. La FB fue diagnóstica en 17 casos. Todas las neoplasias fueron diagnosticadas con alguna de estas 2 técnicas. El cultivo de la PAPT fue positivo en el 90% (19/21) de los APSN, siendo H. influenzae la bacteria más frecuentemente aislada. Los pacientes con APSN presentaron de forma significativa mayor número de cultivos monomicrobianos (14/19 frente a 33/79; p < 0,02), mayor participación de bacterias aerobias (19/19 frente a 45/79; p < 0,001) v menor de anaerobias (4/19 frente a 52/79; p < 0,001) que los pacientes con AP primario.

Conclusiones

1) La PAPT posee un alto rendimiento en el diagnóstico bacteriológico del APSN y en el del carcinoma asociado. 2) La PAPT complementa a la FB en el diagnóstico de la neoplasia subyacente al AP, evitando recurrir a toracotomías innecesarias. 3) En el APSN intervienen una gran variedad de gérmenes, destacando la participación de bacterias aerobias.

Palabras clave:
Punción aspirativa pulmonar transtorácica
Absceso pulmonar
Carcinoma pulmonar
Objective

To evaluate the usefulness of transthoraeic needle biopsy (TNB) for the diagnosis of bronchial carcinoma underlying lung abscess (LA), and to determine the baeteriology of lung abscess secondary to neoplasm (LASN).

Patients and method

One hundred thirteen consecutive patients diagnosed of LA were enrolled. Radiologically guided TNB was performed on all patients using 20-22 G needles. Microbiological and cytological samples were processed. Fiberoptic bronchoscopy (FB) was performed if there were risk factors for lung cancer. TNB-diagnosed cases were compared with the remaining cases of LA.

Results

Neoplasia was found in 21 LA patients. TNB samples provided diagnostic information in 15 cases, there were 2 false negatives, and no cytology sample was processed in 4 cases. Diagnosis was based on FB in 17 cases. All neoplasias were diagnosed with one technique or the other. TNB culture was positive in 90% (19/21) of the LASN patients, H. influenzae being the most frequently isolated bacterium. The number of cultures that presented a single microbe was significantlv greater (p < 0.02) among LASN patients (14/19 versus 33/79). These patients also had significantly more aerobic bacteria (19/19 versus 45/79; p < 0.001) and fewer anaerobies (4/19 versus 52/79; p < 0.001) than did the primary LA patients.

Conclusions

1) TNB is highly useful for arriving at a bacteriologic diagnosis of LASN and in associated cancer. 2) TNB complements FB for the diagnosis of neoplasia underlying LA and helps to reduce the number of unnecessary thoracotomies. 3) A great variety of germs, particularly aerobic bacteria, are implicated in LASN.

Keywords:
Transthoracic needle biopsy
lung abcess
Lung cancer
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Copyright © 1996. Sociedad Española de Neumología y Cirugía Torácica
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