Extreme Thoracic Biopsies
Percutaneous transthoracic biopsy is a commonly used procedure in the diagnosis of intrathoracic pathology. With modern imaging and interventional devices, percutaneous transthoracic biopsy allows access to locations inaccessible by mediastinoscopy or bronchoscopic biopsy. This chapter presents tips for performing successful percutaneous biopsy of lesions in precarious intrathoracic locations. The practices highlighted should help maximize the chances for a successful tissue yield while minimizing the rate of biopsy-associated complications. Mediastinal, hilar, and juxtapleural lesions present anatomic challenges that can decrease the chance of safely obtaining tissue and increase complication rates. The use of techniques to displace injury-prone anatomical structures and to open access windows can allow the interventionalist to obtain diagnostic tissue samples from almost all intrathoracic locations. A well-planned approach is the most important factor in maximizing yield and preventing complications.