Solitary pulmonary nodule diagnostic study of choice
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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
Lung biopsy is the study of choice to diagnose pulmonary nodule. 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 positron emission tomography scan.
Diagnostic Study of Choice
Study of Choice
Biopsy
- Biopsy for pulmonary nodule may be classified into 2 categories:[1]
1. Non-surgical Biopsy
- Bronchoscopy
- Transthoracic needle aspiration
- Needle core biopsy
2. Surgical
- 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 positron emission tomography (PET) scan
- Determination of tumor histologic sub-type
- Characterization of genetic mutations
- Contraindications for biopsy in pulmonary nodule include:[1]
- Complications of taking biopsy in pulmonary nodule include:[1]
- Pneumothorax
- Hemothorax For more information about surgical biopsy of pulmonary nodule, click here.
Non-surgical Procedures for Taking Biopsy
Bronchoscopy
- Common bronchoscopy biopsy techniques for pulmonary nodule include:[1][2]
- Conventional bronchoscopic-guided transbronchial biopsy
- Bronchoscopic-transbronchial needle aspiration (preferred technique)
- Endobronchial ultrasound-guided sheath transbronchial biopsy
- Endobronchial ultrasound-guided 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
- When patients are at risk of complications from any other procedures of taking biopsy
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
References
- ↑ 1.0 1.1 1.2 1.3 1.4 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 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.