Pulmonary hemorrhage after percutaneous pleural nodule biopsy

Case contributed by Dr Bruno Di Muzio

Presentation

Indeterminate pleural nodule.

Patient Data

Age: 64
Gender: Male

CT images show a co-axial needle into the pleural nodule. After the procedure, control images show a small local pneumothorax and an intra-alveolar hemorrhage seen as ground-glass infiltrates in local lung parenchyma.

Case Discussion

The advanced position of the co-axial needle into the pleural nodule is the most likely cause of a possible lung punching by the core-biopsy needle. 

Parenchymal hemorrhage is a possible complication of thoracic biopsy and is typically self-limited. Hemoptysis can be the presenting symptom, as was the case in this patient. 

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