Case 143: Long Parallel Approach to Small Pleural Lesions

Table of Contents

Table of Contents

Table of Contents

CT Guided BiopsyBhavin Jankharia

Previous Case:

Case 142: Sub 5 mm Lung Nodule Biopsy

Sub 5 mm lung nodules can be biopsied safely by following a few simple principles and steps

CT Guided BiopsyBhavin Jankharia

Current Case:

A 71-years old with carcinoma tongue, treated 7 months prior presented with right pleural effusion and small pleural nodules.

She was referred for a CT guided biopsy. The nodule shown was the most accessible, measuring 2.4 mm in thickness.

There are typically two options - going perpendicular or parallel

The video discusses the case, the approach to this nodule and basic principles of performing pleural biopsies as far as possible using a parallel approach

Region: Pleura
Age: 71 yrs
Findings: Pleural effusion and pleural nodules
Lesion Biopsied: Posterior mid-thoracic pleural nodule
Size of Lesion: 2.4 mm transverse thickness
Gun: 20G Cook, 10 mm throw, long
No of cores: 6 for histopath and 2 for microbiology
Sedation: No
Position & Approach: Prone, from left to right - parallel to pleura
Time Taken (marker to wash-out): 12 mins
Complication: None
Level of Difficulty: 4/5
Diagnosis: Metastatic poorly differentiated squamous cell carcinoma, consistent with tongue primary

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