Pulmonary nodule biopsy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Biopsy for pulmonary nodule may be classified into 2 categories: non-surgical biopsy and surgical biopsy. Biopsy findings associated with pulmonary nodule will depend on tumor histology. Common types of lung tissue biopsy for solitary pulmonary nodule, include: conventional bronchoscopic-guided transbronchial biopsy, bronchoscopic-transbronchial needle aspiration, endobronchial ultrasound-guided sheath transbronchial biopsy, and endobronchial ultrasound-guided transbronchial needle aspiration. Common indications for biopsy in pulmonary nodule, include: high risk nodule (> 65%), intermediate risk nodule with a high risk patient profile, intermediate risk nodule with a positive positive positron emission tomography scan.[1][2]
Biopsy
Biopsy for pulmonary nodule may be classified into 2 categories:[1]
- Non-surgical biopsy
- Bronchoscopy
- Transthoracic needle biopsy
- Needle core biopsy
- Surgical
- Wedge resection
- Indications for biopsy in pulmonary nodule, include:[1]
- High risk nodule (> 65%)
- Intermediate risk nodule, with a high risk patient profile
- Intermediate risk nodule, with a positive positive positron emission scan (PET) scan
- Determination of tumor histologic subtype
- Characterization of genetic mutations
- Contraindications for biopsy in pulmonary nodule, include:[1]
- Emphysema
- Bullous disease
- Chronic respiratory failure
- Complications for for biopsy in pulmonary nodule, include:[1]
- Pneumothorax
- Hemothorax
Non-Surgical Biopsy
Bronchoscopy
- Conventional bronchoscopic-guided transbronchial biopsy
- Bronchoscopic-transbronchial needle aspiration
- Endobronchial ultrasound-guided sheath transbronchial biopsy
- Endobronchial ultrasound-guided transbronchial needle aspiration
- The preferred bronchoscopy biopsy techinque for pulmonary nodule is bronchoscopic-transbronchial needle aspiration.
- Indications for bronchoscopy in pulmonary nodule, include:[2]
- Central nodules
- Large lesions
- No fitness for surgery
- Nodules close to the patent airways
- Patients were the risk of complications from any other biopsy is high
Transthoracic needle biopsy
- Usually followed by CT guidance
- Indications for transthoracic needle biopsy in pulmonary nodule, include:[2]
- Peripheral nodules
- Nodules close to the chest wall
- No fitness for surgery
Surgical Biopsy
- For more information about surgical biopsy of pulmonary nodule, click here
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Herman M, Galanter M, Lifshutz H (1991). "Combined substance abuse and psychiatric disorders in homeless and domiciled patients". Am J Drug Alcohol Abuse. 17 (4): 415–22. PMID 1746503.
- ↑ 2.0 2.1 2.2 2.3 Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM (2004). "Percutaneous biopsy in evaluation of lung nodules". JSLS. 8 (3): 213–6. PMC 3016799. PMID 15347106.