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Indications for Lung Biopsy
Patients with
lesions on the chest radiograph
should be discussed in a
multidisciplinary meeting with a
respiratory physician and
radiologist at a minimum.
Percutaneous
transthoracic lung biopsy
(PTLB) should be considered in the
following:
-
New or
enlarging solitary nodule or
mass on the chest radiograph which
is not amenable to diagnosis
by bronchoscopy or CT shows it
is unlikely to be accessible
by bronchoscopy.
-
Multiple
nodules in a patient
not known to have malignancy or
who has had a prolonged
remission or more than one primary
malignancy.
-
Persistent
focal infiltrates,
either single or multiple, for
which no diagnosis has
been made by sputum or blood
culture, serology, or bronchoscopy.
-
Hilar mass
following negative bronchoscopy.
Relative
Contraindications to Lung Biopsy
-
Abnormalities
of lung function,
-
Respiratory
failure (including mechanical
ventilation),
-
Arterial and
venous pulmonary hypertension,
-
Coagulation
abnormalities,
-
The
uncooperative patient.
Complications of
Lung Biopsy
-
Pneumothorax
(20.5% of biopsies),
-
Pneumothorax
requiring a chest drain
(3.1%),
-
Haemoptysis
(5.3%), and
-
Death (0.15%).
Related Criteria
Light Criteria for Exudative Pleural Effusion
GINA Classification of Asthma Severity
GOLD Staging
System for Chronic Obstructive Lung
Disease (COPD) Severity
ATS/ERS Criteria for Diagnosis
of Idiopathic Pulmonary Fibrosis (IPF)
in Absence of Surgical Lung Biopsy
More...
References:
-
Manhire A, Charig M,
Clelland C, Gleeson F,
Miller R, Moss H,
Pointon K, Richardson
C, Sawicka E; BTS.
Guidelines for
radiologically guided
lung biopsy. Thorax.
2003
Nov;58(11):920-36.
[Medline]
-
The
Diffuse Parenchymal
Lung Disease Group of
British Thoracic
Society. The
diagnosis, assessment
and treatment of
diffuse parenchymal
lung disease in
adults. Introduction.
Thorax. 1999 Apr;54
Suppl 1:S1-14.
[Medline]
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