Objectives: This study aimed to evaluate the diagnostic yield and complications associated with computed tomography (CT)-guided transthoracic core-needle biopsy (CNB) of lung lesions and to identify factors influencing biopsy outcomes. Methods: This retrospective study included patients who underwent CT-guided CNB of lung lesions at Sultan Qaboos Comprehensive Cancer Care & Research Centre, University Medical City, Muscat, Oman, from November 2021 to December 2024. Patients were categorised as either having undiagnosed lung masses/nodules or suspected pulmonary metastases from known malignancies. Biopsies were performed using an 18-gauge coaxial needle, following standard protocols. Diagnostic yield, sample adequacy for molecular analysis and complications were analysed using descriptive statistics and Chi-squared or Fisher's exact tests. Results: A total of 105 patients were included. Diagnostic yield of CT-guided CNB was 81.9% (n = 86) with malignancy confirmed in 72.4% of cases. Diagnostic yield significantly correlated with lesion size with increasing accuracy for lesions >2.1 cm compared to those <1 cm (93.9% versus 55%; P = 0.003). Lesion morphology, localisation, positron emission tomography guidance and patient demographics had no significant effects statistically. Complications in 28.8% of patients were largely pneumothorax (21.2%), followed by haemoptysis (8.7%) and haemothorax (1.9%). Smaller lesions (5 cm) had higher rates of complications (P = 0.007 and P = 0.080, respectively). Conclusion: CT-guided lung biopsy demonstrated high diagnostic yield with acceptable rates of complications. Lesion depth and size had significant impacts on diagnostic success and occurrence of complications. These results support that CT-guided CNB is a safe and reliable diagnostic procedure for lung lesions, especially when lung lesions are superficially located and solid.

We report the case of a 47-year-old woman who presented with left inguinal swelling; the biopsy of which showed high-grade serous adenocarcinoma. ⁶⁸ Ga-FAPI PET/CT revealed a tracer-avid lesion in the left adnexal region and an enlarged left inguinal nodal mass (site of biopsy). Multiple focal lesions were also seen at the hepatic dome, along the falciform ligament and at the right lateral abdominal wall, suspicious for peritoneal/metastatic deposits. The patient received 3 cycles of neoadjuvant chemotherapy, followed by interval debulking surgery. Tumor was seen in the left fallopian tube, but not in the ovaries. ⁶⁸ Ga-FAPI PET/CT provides better lesion localization due to a higher tumor-to-background ratio.

Malignant gastrointestinal neuroectodermal tumor (GNET), also referred to as clear cell sarcoma-like tumor of the GI tract is a rare mesenchymal tumor of the gastrointestinal tract. It has to be distinguished from various mimickers including gastrointestinal stromal tumor (GIST) due to its aggressive course and different natural history and therapeutic approach. Here we report a case of GNET arising in the small intestine with aberrant DOG1 expression posing a diagnostic challenge. In this context, the combination of clinical, histomorphological, immunohistochemical, and molecular features helped to establish a proper diagnosis.

Tc-99m methylene diphosphonate (MDP) is a bone imaging agent used for skeletal staging, but it can also be localized in extraosseous calcifying lesions. We report a case of an 84-year-old woman with breast carcinoma who underwent surgery followed by radiotherapy 10 years ago and now presented with a right axillary mass referred for Tc-99m MDP to exclude bone metastasis. Tc-99m MDP shows intense tracer uptake in the right thoracic region corresponding to the site of calcified soft tissue mass in the right lateral chest wall. Subsequent ultrasonography revealed an ill-defined lesion containing coarse calcifications. Biopsy showed radiation-induced sarcoma. Extra osseous Tc-99m MDP uptake may provide important diagnostic information that may alter patient management.

Warthin-like papillary thyroid carcinoma (WL-PTC); A rare case series and review of literature - OCC- Print ISSN No: - Online ISSN No:- 3048-6289 Article DOI No:- 10.18231/j.occ.2024.004, Onco Critical Care-Onco Crit Care

Cytologic diagnosis of extra-adrenal paraganglioma presenting as a peripancreatic mass is challenging, with a high rate of diagnostic error. We present a case of a peripancreatic mass identified by radiology as a gastrointestinal stromal tumor. Endoscopic ultrasound-guided fine-needle aspiration (FNA) of the mass showed a moderately cellular tumor composed of small-to-medium-sized neoplastic cells with round-to-oval nuclei arranged singly and in loose clusters. The cells were positive for neuroendocrine markers (synaptophysin and chromogranin) and negative for CD117. A diagnosis of neoplasm with a neuroendocrine tumor (NET) was made based on FNA cytology. The subsequent surgical resection of the tumor revealed peripancreatic paraganglioma with immunohistochemistry positive for synaptophysin, chromogranin, and S100. The latter delineated the sustentacular cells. Although paraganglioma is a well-recognized tumor, a detailed comparison of peripancreatic paraganglioma versus pancreatic/gastrointestinal NET is still lacking.