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Percutaneous Lung Biopsy in a Patient with a Cavitating Lung Mass: Indications, Technique, and Complications

Michael M. Maher1,2, Mannudeep K. Kalra2, Ross L. Titton2, Giles W. Boland2, Conrad Wittram1, Suzanne Aquino1, Peter R. Mueller2 and Jo-Anne O. Shepard1

1 Division of Thoracic Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114.
2 Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, Boston, MA.



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Fig. 1 Frontal chest radiograph showing left upper lobe opacity suggestive of lung mass. Left hilar mass is present.

 


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Fig. 2A Contrast-enhanced CT of chest. Scan showing 3.5 x 4 cm left upper lobe mass with central cavitation.

 


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Fig. 2B Contrast-enhanced CT of chest. Scan showing left hilar mass, consistent with left hilar lymphadenopathy.

 


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Fig. 3 18F-FDG PET scan showing avid uptake in left upper lobe mass and in left hilum (arrows), suggesting left upper lobe neoplasm with ipsilateral lymphadenopathy.

 


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Fig. 4 CT scan showing importance of visualization of entire needle track in same plane as lesion to increase likelihood that needle will reach lesion after pleural puncture.

 


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Fig. 5 CT scan showing satisfactory final needle position, with needle positioned in wall away from cavity.

 

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