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 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).

Other Diagnostic Studies

Biopsy

Biopsy for lung mass may be classified into 2 categories:

• 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:

• Suspected lung cancer
• Determination of tumor histologic subtype
• Characterization of genetic mutations

• Contraindications for biopsy in lung mass, include:

• Emphysema
• Bullous disease
• Chronic respiratory failure

• Complications for biopsy in lung mass, include:

• Pneumothorax
• Hemothorax

Non-Surgical Biopsy

Bronchoscopy

• Common bronchoscopy biopsy techniques for lung mass, include:

• 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:

• 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 mass include:

• 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