Lung mass biopsy: Difference between revisions

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__NOTOC__
{{Lung mass}}
{{CMG}}{{AE}}{{MV}}


==Overview==
Biopsy for lung mass may be classified into 2 categories: non-surgical biopsy and surgical biopsy. Biopsy findings associated with lung mass will depend on tumor [[histology]]. Common types of lung tissue biopsy for pulmonary mass, 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 lung mass, include: suspected lung cancer, malignant features (lymph node involvement).<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
==Biopsy==
Biopsy for lung mass may be classified into 2 categories:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Bronchoscopy
:*Transthoracic needle biopsy
:*Needle core biopsy
*'''Surgical'''
:* Wedge resection
* The preferred biopsy technique for lung mass is wedge resection.
*Indications for biopsy in lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Suspected lung cancer
:*Determination of tumor histologic subtype
:*Characterization of genetic mutations
*Contraindications for biopsy in lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Emphysema
:*Bullous disease
:*Chronic respiratory failure
*Complications for for biopsy in lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Pneumothorax
:*Hemothorax
==Non-Surgical Biopsy==
'''Bronchoscopy'''
*Common bronchoscopy biopsy techniques for lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Conventional bronchoscopic-guided transbronchial biopsy
:*Bronchoscopic-transbronchial needle aspiration
:*Endobronchial ultrasound-guided sheath transbronchial biopsy
:*Endobronchial ultrasound-guided transbronchial needle aspiration
*Indications for bronchoscopy in lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*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:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Peripheral nodules
:*Nodules close to the chest wall
:*No fitness for surgery
==Surgical Biopsy==
*Surgical excision is the mainstay therapy for malignant lung mass
*Surgical excision is also the primary choice for the definitive diagnosis of malignant lung mass
*In lung mass, surgical procedure selection will depend on the size, margins, and size of the tumor.
*Common surgical procedures for the treatment of lung mass, include:
:*Wedge resection
:*Lobectomy
:*Segmentectomy
:*Lung volume reduction surgery
==References==
{{reflist|2}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Pulmonology]]
[[Category:Surgery]]

Latest revision as of 16:38, 27 February 2018