Advances in Nonsurgical Sampling Techniques for the Diagnosis and Staging of Lung Cancer



A clinician has multiple options when a decision has been made to sample a lesion in the chest for the purposes of diagnosing or staging an intrathoracic malignancy. Suspected primary or metastatic parenchymal lesions may be amenable to percutaneous CT-guided needle biopsy, various bronchoscopic approaches, or surgical sampling. When selecting from among these options, the overriding goal should be to obtain all of the information needed for diagnosis and staging with the least risk to the patient. This chapter will address some of the more commonly used nonsurgical techniques employed for sampling known or suspected intrathoracic malignancies, with emphasis on recently developed techniques, including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), endobronchial ultrasound-guided sampling of peripheral nodules using radial probe technology (RP-EBUS), and electromagnetic navigational bronchoscopy (ENB), as well as established modalities such as CT-guided needle aspiration (CTNA) and CT-guided needle biopsy (CTNB). The optimal paradigm for care of the patient with lung cancer involves communication and coordination between the cytopathologist and the clinician who is choosing a sampling modality. It is therefore critical that the cytopathologist understand the rationale for and the limitations of each of these techniques in order to fully participate in this care.


Airway Wall Pathologic Sampling National Lung Screening Trial Convex Probe Radial Probe 
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© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of RadiologyMount Sinai Medical Center, Mount Sinai HospitalNew YorkUSA
  2. 2.Department of MedicineColumbia University Medical CenterNew YorkUSA

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