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IN spite of several earlier attempts to develop a safe and reliable method, needle biopsy of pulmonary lesions has not become generally accepted in the diagnosis of lung diseases. Complications such as life-threatening bleedings, infection, air embolism and pneumothorax were probably the main reasons for this. In 1960 a critical investigation was made of the possible reasons for the unsuccessful attempts up to that time, among which unsatisfactory roentgen-diagnostic technics and equipment, and probably to some extent inappropriate instruments, seemed to have been important. In systematic attempts to develop a reliable method, about 2000 biopsies have been performed at the . . .

What to do with the patient who shows a pulmonary mass but in whom the usual diagnostic procedures are not particularly helpful? Dr. Dahlgren, a pathologist, and Dr. Nordenstrom, a radiologist, both at the Karolinska Institute, describe the way they avoid any diagnostic impasse by proceeding directly from the stage of negative findings to a needle biopsy. Using a special table and television fluoroscopy, they obtained a satisfactory specimen in 74% of 519 biopsies from 365 cases. Microscopy gave a definitive diagnosis in 316 (87%) of these 365 patients. Regarding complications, the authors state that with a single exception, no signs of air embolism, shock, or other alarming symptoms were noted. In the one exception, a 70-year-old man with a prior myocardial infarct became cold, sweaty, and severely hypotensive about five minutes after the biopsy needle had been withdrawn. The electrocardiogram and transaminase studies indicated that the episode was due

By Sven Dahlgren, M.D., Department of Pathology, and Bjorn Nordenstrom, M.D., Director, Department of Thoracic Radiology, Karolinska Institutet, Stockholm, Sweden. Cloth, $12.50. Pp. 132, with 70 figures. Chicago, Yr. Bk. Pub'rs., 1966. This very good monograph reports in detail on a large clinical experience with transthoracic needle biopsy. The material is well organized, clearly presented, reads easily, and will be a useful basic reference work for all those interested in initiating this technic. The authors have shown quite conclusively that needle biopsy of pulmonary lesions under roentgen television control has been sufficiently developed to become a clinically valuable diagnostic tool. It provides the opportunity for obtaining specific diagnostic information in those lesions that otherwise would not be obtainable except through open thoracotomy and excisional biopsy. Although needle biopsy of pulmonary lesions is not a new procedure, it was never generally accepted as a safe and accurate diagnostic...