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==Overview==
==Overview==


Biopsy findings associated with pulmonary nodule will depend on tumor [[histology]], common findings include:
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 scan (PET) scan.
Common types of lung tissue biopsy for solitary pulmonary nodule, include: open biopsy, video-assisted thoracoscopic surgery, non-surgical biopsy  
 
==Biopsy==
==Biopsy==
 
Biopsy for pulmonary nodule may be classified into 2 categories:
*Common types of lung tissue biopsy, include:<ref name="pmid12820712">{{cite journal |vauthors=Yung RC |title=Tissue diagnosis of suspected lung cancer: selecting between bronchoscopy, transthoracic needle aspiration, and resectional biopsy |journal=Respir Care Clin N Am |volume=9 |issue=1 |pages=51–76 |year=2003 |pmid=12820712 |doi= |url=}}</ref>
*'''Non-surgical biopsy'''
:*Needle biopsy
:*Bronchoscopy
:*Open biopsy
:*Transthoracic needle biopsy
:*Video-assisted thoracoscopic surgery (VATS)
:*Needle core biopsy  
*'''Surgical'''
:* Wedge resection


*Indications for biopsy in pulmonary nodule, include:
*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 scan (PET) scan
:*Determination of tumor histologic subtype  
:*Determination of tumor histologic subtype  
:*Characterization of genetic mutations
:*Characterization of genetic mutations
:*Determination of intra or extra-thoracic metastatic disease
 
*Contraindications for biopsy in pulmonary nodule, include:
:*Emphysema
:*Bullous disease
:*Chronic respiratory failure
 
*Complications for for biopsy in pulmonary nodule, include:
:*Pneumothorax
:*Hemothorax
 
==Non-Surgical Biopsy==
 
'''Bronchoscopy'''
 
*Common bronchoscopy biopsy techniques for pulmonary nodule, include:
:*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:
:*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:
:*Peripheral nodules
:*Nodules close to the chest wall
:*No fitness for surgery
 
==Surgical Biopsy==
 
* For more information about surgical biopsy of pulmonary nodule, click [[solitary pulmonary nodule surgery|here]]


==References==  
==References==  
{{reflist|2}}
{{reflist|2}}

Revision as of 22:05, 17 March 2016

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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 scan (PET) scan.

Biopsy

Biopsy for pulmonary nodule may be classified into 2 categories:

  • Non-surgical biopsy
  • Bronchoscopy
  • Transthoracic needle biopsy
  • Needle core biopsy
  • Surgical
  • Wedge resection
  • 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 scan (PET) scan
  • Determination of tumor histologic subtype
  • Characterization of genetic mutations
  • Contraindications for biopsy in pulmonary nodule, include:
  • Emphysema
  • Bullous disease
  • Chronic respiratory failure
  • Complications for for biopsy in pulmonary nodule, include:
  • Pneumothorax
  • Hemothorax

Non-Surgical Biopsy

Bronchoscopy

  • Common bronchoscopy biopsy techniques for pulmonary nodule, include:
  • 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:
  • 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:
  • 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

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