Lung mass other diagnostic studies
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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 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).[1]
Other Diagnostic Studies
Biopsy
Biopsy for lung mass may be classified into 2 categories:[1]
- 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:[1]
- Suspected lung cancer
- Determination of tumor histologic subtype
- Characterization of genetic mutations
- Contraindications for biopsy in lung mass, include:[1]
- Emphysema
- Bullous disease
- Chronic respiratory failure
- Complications for for biopsy in lung mass, include:[1]
- Pneumothorax
- Hemothorax
Non-Surgical Biopsy
Bronchoscopy
- Common bronchoscopy biopsy techniques for lung mass, include:[1]
- 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:[1]
- 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:[1]
- 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