Percutaneous transthoracic needle aspiration of the lung. Diagnosing Pneumocystis carinii pneumonitis
S. Chaudhary, W. T. Hughes, S. Feldman, S. K. Sanyal, T. Coburn, M. Ossi and F. Cox
Percutaneous transthoracic needle aspiration was performed on 228 occasions
to obtain lung specimens from 202 patients with suspected Pneumocystis
carinii pneumonitis. In 121 patients the diagnosis was established by
identifying P carinii organisms in lung aspirates. Six patients whose
aspirates did not contain P carinii were found to have the organism at
autopsy. Findings from toluidine blue O and Gomori methenamine silver
nitrate stains were equally satisfactory for detecting P carinii, but the
percentage of specific diagnosis was higher when specimens were stained
with both. Pneumothorax that required a thoracotomy tube occurred in 39
patients. Other infectious agents, either bacteria or fungi, were found in
only four patients. Percutaneous pulmonary needle aspiration--when
performed under fluoroscopic guidance--is a rapid and effective method for
the diagnosis of P carinii pneumonitis.