Editing Lung nodules (section)

== Options for biopsy: ==

* Diagnostic bronchoscopy
** Good for central lesions >20mm or for lesions with a visible bronchogram reaching into the nodule - yield 80% when these features are present, 34% when not
* Navigational bronchoscopy
* EBUS
* Trans-thoracic needle aspiration
** Risks:
*** PTX (overall 20-50%, requiring percutaneous drainage 10%)
*** Bleeding
*** Infection
*** Gas embolism
*** Tumour seeding
** FEV1 >1L considered safe for biopsy, but beware of patients with pulmonary fibrosis who may have a lower reserve than predicted by FEV1
* VATS and sub-lobar resection with frozen section
** Indicated in peripheral lesions with high probability of malignant disease
** For small lesions far from pleural surface, pre-operative localisation techniques can be used
** Intra-operative USS can also help
* VATS and lobectomy
* Pneumonectomy 
** Should not be performed without a cancer diagnosis




[[Category:Thoracics]]