Planning the approach for lung biopsy carefully is vital.
A big mass doesn't always mean an easy biopsy.
Prone (oblique fissure and ribs) and lateral (axillary vessels) approaches in this case have obstructing structures.
An anterior appears best, but it is a deep transpectoral muscle biopsy, traversing a lot of lung.
The two main potential complications are:
- pneumothorax
- hemoptysis
This biopsy required all 11cm of the co-axial needle to reached the mass. A single pass and single core was taken.
In this case, the patient had post-procedural hemoptysis (5-10mls) which self-resolved.
Life lesson - even when a procedure is performed to plan it doesn't mean it will be free of complications.
HISTOLOGY: Adenocarcinoma of the lung