Presentation
Cough and lethargy. Lung mass?
Patient Data
Large lobulated mass in the right lower lobe extending to the pleural surface. No intralesional calcification.
No pleural thickening.
The background lung parenchyma is normal.
Prone position.
Surface markers to plan biopsy approach.
Stages of biopsy using a co-axial needle set.
Small post procedural pneumothorax on check images post biopsy.
Case Discussion
Not every mass in the lung is a malignancy.
You would have your money on this being one by its size and appearance. An initial FNAC did not identify any malignant cells.
On follow up imaging it remained and a core biopsy (two 20G cores) was taken.
It too did not identify malignancy, merely reported as inflammatory cells. No malignant cells. Histological conclusion: Scar tissue
Couple of CT lung biopsy tips.
a. Thin pneumothoraces developing post procedure are common.
Half fill a syringe with saline and aspirate the pneumothorax with the co-axial needle prior to withdrawal. The air will bubble in the saline. Stop aspirating when the bubbling stops.
2. Window manually for needle tip positions throughout.
Notice the difference on the mediastinal and manually windowed 'lung' windows in the procedural steps.
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