Needle biopsy of a pulmonary nodule - Thoracic Imaging

Title: Thoracic Imaging - Needle biopsy of a pulmonary nodule
Diagnosis: Needle biopsy of a pulmonary nodule
Author: Martins Martina
Comment: Howarth Nigel
Hospital: HUG
Department: Département de Radiologie
State: Terminée
Date: 21.03.2003
: 3402
KeyWords: Nodule; needle biopsy;
Anatomy: Thorax
Chapter: Interventional
ACR: 6.43

Clinical Presentation: Previous history of cervical and endometrialcancer, with
vaginal recurrence treated with surgery and radiationtherapy.
Comment: Diagnosis based on histology and cytology analyses:squamous cell
pulmonary carcinoma. The CT-guided biopsy isperformed as follows: * Patient installed on
the CT table inventral, dorsal or lateral recumbency, depending on the lesioníslocalisation
* CT Images centred on the lesion with intravenouscontrast medium injection and
radiopaque marker on the skin * Thedistance between the puncture site and the lesion is
measured *Local anesthesia and transthoracic needle biopsy * Post-biopsycontrol images
The most common complications are pneumothorax andhemoptysis. Air embolism is a
serious but fortunately rarecomplication.
Description: The chest X-ray shows a nodule in the left upper lobe.CT images are
used to locate the nodule and guide the transthoracicneedle biopsy under local
anesthesia. The biopsy was performed withan 18-gauge cutting needle. Post-biopsy
control images confirm theabsence of pneumothorax or effusion.

Order: 0
Dislocation: 0
Polytrauma: 0
Open: 0
Pathologic: 0
Operation: 00.00.00
Graft: 0

References: Arnold BW, Zwiebel WJ. Percutaneous transthoracicneedle biopsy
complicated by air embolism. AJR 2002;178:1400-2.Lucidarme O, Howarth N. Radiologie
interventionnelle thoracique.Encycl Méd Chir, Radiodiagnostic - Coeur-Poumon.
2001;32-500-A-10.Ghaye B, Dondelinger RF. Imaging guided thoracic interventions.
EurRespir J 2001;17:507-28. Lucidarme O, Howarth N, Finet JF, GrenierPA.
Intrapulmonary lesions: percutaneous automated biopsy with adetachable, 18-gauge
coaxial cutting needle. Radiology1998;207:759-765. Westcott JL. Percutaneous
transthoracic needlebiopsy. Radiology 1988;169:593-601.

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