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==Overview==
==Overview==
[[Biopsy]] for lung mass may be classified into 2 categories such as 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).
[[Biopsy]] of a 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 (biology)|tissue]] [[biopsy]] for lung 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 [[Indication (medicine)|indications]] for [[biopsy]] in lung mass include suspected [[lung cancer]] and [[malignant]] features ([[lymph node]] involvement).


==Other Diagnostic Studies==
==Other Diagnostic Studies==
===Biopsy===
===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>
[[Biopsy]] of a 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]]
===1. Non-surgical Biopsy===
**Transthoracic [[needle biopsy]]
**Needle core biopsy
*Surgical
** [[Wedge resection (lung)|Wedge resection]]
** The preferred [[biopsy]] technique for lung mass is [[Wedge resection (lung)|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>
'''Bronchoscopy'''
**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 [[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|bronchoscopic]] [[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 [[Bronchoscopy|bronchoscopic]]-guided [[Bronchial|transbronchial]] [[biopsy]]
**[[Bronchoscopy|Bronchoscopic]]-[[Bronchial|transbronchial]] [[Needle aspiration biopsy|needle aspiration]]
**Endobronchial [[ultrasound]]-guided sheath [[Bronchial|transbronchial]] [[biopsy]]
**Endobronchial [[ultrasound]]-guided [[Bronchial|transbronchial]] [[Needle aspiration biopsy|needle aspiration]]


*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>
*[[Indication (medicine)|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>
**Conventional bronchoscopic-guided transbronchial biopsy
**Central [[nodules]]
**Bronchoscopic-transbronchial needle aspiration
**Large [[Lesion|lesions]]
**Endobronchial ultrasound-guided sheath transbronchial biopsy
**[[Contraindication]] to [[surgery]]
**Endobronchial ultrasound-guided transbronchial needle aspiration
**[[Nodules]] close to the patent [[Airway|airways]]
**[[Patient|Patients]] who are at risk of [[Complication (medicine)|complications]] from other types of [[biopsy]] taking


*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>
'''Transthoracic Needle Biopsy'''
**Central [[nodules]]  
*Usually done by [[CT]] guidance
**Large lesions
*[[Indication (medicine)|Indications]] for transthoracic [[needle biopsy]] in pulmonary 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>
**No fitness for surgery
**Peripheral [[nodules]]
**[[Nodules]] close to the patent airways
**[[Nodules]] close to the [[chest wall]]
**Patients were the risk of complications from any other [[biopsy]] is high
**[[Contraindication]] to [[surgery]]


'''Transthoracic needle biopsy'''
===2. Surgical Biopsy===
*Usually followed by [[CT]] guidance
*Indications for transthoracic [[needle biopsy]] in pulmonary 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>
**Peripheral [[nodules]]
**Nodules close to the [[chest wall]]
**No fitness for [[surgery]]


==Surgical Biopsy==
*[[excision|Surgical excision]] is the mainstay [[therapy]] for [[malignant]] lung mass.
*Surgical [[excision]] is the mainstay therapy for malignant lung mass.
*[[excision|Surgical excision]] is also the primary choice for the definitive [[diagnosis]] of [[malignant]] lung mass.
*Surgical [[excision]] is also the primary choice for the definitive [[diagnosis]] of [[malignant]] lung mass.
*In lung mass, [[Surgery|surgical procedure]] selection will depend on the size, margins, and location of the [[tumor]].
*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:  
*Common surgical procedures for the treatment of lung mass, include:  
**[[Wedge resection (lung)|Wedge resection]]
**[[Wedge resection (lung)|Wedge resection]]  
**[[Lobectomy of lung|Lobectomy]]
**[[Lobectomy of lung|Lobectomy]]  
**Segmentectomy
**Segmentectomy  
**[[Lung]] volume reduction [[surgery]]
**Lung volume reduction surgery


==References==
==References==

Latest revision as of 20:20, 24 June 2019

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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] Akshun Kalia M.B.B.S.[3]

Overview

Biopsy of a 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 lung 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 and malignant features (lymph node involvement).

Other Diagnostic Studies

Biopsy

Biopsy of a lung mass may be classified into 2 categories:[1]

1. Non-surgical Biopsy

Bronchoscopy

Transthoracic Needle Biopsy

2. Surgical Biopsy

References

  1. 1.0 1.1 1.2 1.3 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.