Transthoracoscopic needle biopsy for indeterminate lung nodules

Background: The usefulness of transthoracoscopic needle biopsy for preopera tively indeterminate intrapulmonary nodules was evaluated. Methods: Thoracoscopy was performed on 38 patients with pulmonary solitary nodules suspected to be primary lung carcinomas. When the nodule was locali zed by simple observation or tactile sensor, a biopsy specimen of the tumor was obtained by a biopsy needle introduced through a trocar. Results: The nodules were 7 to 55 mm in diameter. All were located in the p eripheral region of the lung. Biopsy specimens were obtained even from 17 n odules with no associated pleural changes. By cytology, all the malignant t umors were precisely diagnosed, 29 as primary lung cancers and 3 as metasta tic lung neoplasms. Five of the remaining six benign nodules were not preci sely diagnosed. However, they were cytologically classified as class I. Conclusions: Transthoracoscopic needle biopsy is feasible for diagnosing sm all intrapulmonary nodules, particularly those of malignant neoplasms. As c ompared with thoracoscopic excisional biopsy, transthoracoscopic needle bio psy saves time and may reduce the possibility of tumor dissemination during the procedure.