CT guided lung biopsy - deep transpectoral

Case contributed by Ian Bickle , 2 Feb 2017
Diagnosis not applicable
Changed by Frank Gaillard, 6 Feb 2017

Updates to Study Attributes

Findings was changed:

Large spiculated right upper lobe mass.

Surface markers applied.

Anterior transpectoral route.

No post procedural pneumothorax or perilesional haemorrhage.

Updates to Case Attributes

Body was changed:

Planning the approach for lung biopsy carefully is vital.

A big mass doesn't always mean an easy biopsy.

Prone (oblique fissure and ribs) and lateral (axillary vessels) approaches in this case have obstructing structures.

An anterior appears best, but it is a deep transpectoral muscle biopsy, traversing a lot of lung.

The two main potential complications are:

1.  pneumothorax.

2.  haemoptysis.

  1. pneumothorax
  2. haemoptysis

This biopsy required all 11cm of the co-axial needle to reached the mass.  A single pass and single core was taken.

In this case, the patient had post procedural-procedural haemoptysis (5-10mls) which self resolved-resolved.

Life lesson - even when a procedure is performed to plan it doesn't mean it will be free of complications.

HISTOLOGY:   Adenocarcinoma of the lung

  • -<p>Planning the approach for lung biopsy carefully is vital.</p><p>A big mass doesn't always mean an easy biopsy.</p><p>Prone (oblique fissure and ribs) and lateral (axillary vessels) approaches in this case have obstructing structures.</p><p>An anterior appears best, but it is a deep transpectoral muscle biopsy, traversing a lot of lung.</p><p>The two main potential complications are:</p><p>1.  pneumothorax.</p><p>2.  haemoptysis.</p><p>This biopsy required all 11cm of the co-axial needle to reached the mass.  A single pass and single core was taken.</p><p>In this case the patient had post procedural haemoptysis (5-10mls) which self resolved.</p><p>Life lesson - even when a procedure is performed to plan it doesn't mean it will be free of complications.</p><p>HISTOLOGY:   Adenocarcinoma of the lung</p><p> </p><p> </p>
  • +<p>Planning the approach for lung biopsy carefully is vital.</p><p>A big mass doesn't always mean an easy biopsy.</p><p>Prone (oblique fissure and ribs) and lateral (axillary vessels) approaches in this case have obstructing structures.</p><p>An anterior appears best, but it is a deep transpectoral muscle biopsy, traversing a lot of lung.</p><p>The two main potential complications are:</p><ol>
  • +<li>pneumothorax</li>
  • +<li>haemoptysis</li>
  • +</ol><p>This biopsy required all 11cm of the co-axial needle to reached the mass.  A single pass and single core was taken.</p><p>In this case, the patient had post-procedural haemoptysis (5-10mls) which self-resolved.</p><p>Life lesson - even when a procedure is performed to plan it doesn't mean it will be free of complications.</p><p>HISTOLOGY:   <a title="Adenocarcinoma of the lungs" href="/articles/adenocarcinoma-of-the-lung">Adenocarcinoma</a> of the lung</p>

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