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Multidisciplinary approach to thoracic tissue sampling.

Quint LE - Cancer Imaging (2010)

Bottom Line: When choosing the best method to undertake a biopsy of a lesion in the lung or mediastinum, it is important to consider the entire range of possible options, such as surgical, bronchoscopic/endoscopic, and radiologic techniques.Features to be considered include the anatomic location of the lesion, the amount of tissue needed, cost, availability of specific techniques, safety and risks, and expected diagnostic yield/accuracy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University of Michigan Health System, Ann Arbor, MI 48109, USA.

ABSTRACT
When choosing the best method to undertake a biopsy of a lesion in the lung or mediastinum, it is important to consider the entire range of possible options, such as surgical, bronchoscopic/endoscopic, and radiologic techniques. Features to be considered include the anatomic location of the lesion, the amount of tissue needed, cost, availability of specific techniques, safety and risks, and expected diagnostic yield/accuracy.

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Related in: MedlinePlus

A 71-year-old female with a growing left lower lobe ground glass nodule at CT (arrow) and a history of previously resected right upper lobe non-small cell lung cancer. CT-guided biopsy was non-diagnostic. The nodule was subsequently marked with indigo carmine dye using bronchoscopy with electromagnetic navigation and then resected using VATS. Histologic analysis revealed bronchioloalveolar cell carcinoma.
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Figure 1: A 71-year-old female with a growing left lower lobe ground glass nodule at CT (arrow) and a history of previously resected right upper lobe non-small cell lung cancer. CT-guided biopsy was non-diagnostic. The nodule was subsequently marked with indigo carmine dye using bronchoscopy with electromagnetic navigation and then resected using VATS. Histologic analysis revealed bronchioloalveolar cell carcinoma.

Mentions: VATS may be used to sample and perform wedge resection on lesions in the peripheral third of the lung (Fig. 1)[4]. Complications (∼5% rate) include prolonged air leak and bloody pleural effusion. If necessary, small and/or deep lesions may be preoperatively marked with dye, radioactive material, microcoils or wires to aid localization at surgery; such marking may be done using CT guidance or bronchoscopic guidance. Advantages of VATS include the ability to sample lymph nodes and pleural lesions at the same sitting. In addition, VATS enables actual lesion resection, rather than just sampling, leading to a large amount of tissue for analysis and potential cure for small cancers. Disadvantages include the need for general anesthesia, possible overnight hospital stay and cost (∼$18,000 USD).Figure 1


Multidisciplinary approach to thoracic tissue sampling.

Quint LE - Cancer Imaging (2010)

A 71-year-old female with a growing left lower lobe ground glass nodule at CT (arrow) and a history of previously resected right upper lobe non-small cell lung cancer. CT-guided biopsy was non-diagnostic. The nodule was subsequently marked with indigo carmine dye using bronchoscopy with electromagnetic navigation and then resected using VATS. Histologic analysis revealed bronchioloalveolar cell carcinoma.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2967143&req=5

Figure 1: A 71-year-old female with a growing left lower lobe ground glass nodule at CT (arrow) and a history of previously resected right upper lobe non-small cell lung cancer. CT-guided biopsy was non-diagnostic. The nodule was subsequently marked with indigo carmine dye using bronchoscopy with electromagnetic navigation and then resected using VATS. Histologic analysis revealed bronchioloalveolar cell carcinoma.
Mentions: VATS may be used to sample and perform wedge resection on lesions in the peripheral third of the lung (Fig. 1)[4]. Complications (∼5% rate) include prolonged air leak and bloody pleural effusion. If necessary, small and/or deep lesions may be preoperatively marked with dye, radioactive material, microcoils or wires to aid localization at surgery; such marking may be done using CT guidance or bronchoscopic guidance. Advantages of VATS include the ability to sample lymph nodes and pleural lesions at the same sitting. In addition, VATS enables actual lesion resection, rather than just sampling, leading to a large amount of tissue for analysis and potential cure for small cancers. Disadvantages include the need for general anesthesia, possible overnight hospital stay and cost (∼$18,000 USD).Figure 1

Bottom Line: When choosing the best method to undertake a biopsy of a lesion in the lung or mediastinum, it is important to consider the entire range of possible options, such as surgical, bronchoscopic/endoscopic, and radiologic techniques.Features to be considered include the anatomic location of the lesion, the amount of tissue needed, cost, availability of specific techniques, safety and risks, and expected diagnostic yield/accuracy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University of Michigan Health System, Ann Arbor, MI 48109, USA.

ABSTRACT
When choosing the best method to undertake a biopsy of a lesion in the lung or mediastinum, it is important to consider the entire range of possible options, such as surgical, bronchoscopic/endoscopic, and radiologic techniques. Features to be considered include the anatomic location of the lesion, the amount of tissue needed, cost, availability of specific techniques, safety and risks, and expected diagnostic yield/accuracy.

Show MeSH
Related in: MedlinePlus