Thursday, April 24, 2014
A friend underwent lung surgery for a pulmonary nodule. Her doctors advised against a lung biopsy, stating that a biopsy is inconclusive, in that a biopsy might be taken of the part of the nodule that was benign, rather than the part that was malignant. My questions are: Is it common that a nodule is part benign and part malignant? What is your opinion of a lung biospy being inconclusive?
There are two types of lung biopsy. The first is with a thin needle and a radiologist does it using the CT scanner to tell them where to place the needle. This type of biopsy is good in that it is a day procedure. If the biopsy comes back as a cancerous lesion then the answer is achieved. If however, it does not come back as a cancerous lesion that it is said to be non-diagnostic. That is to say, the needle may have been too small to get enough of the nodule or they were not in the nodule at all. It is not that the nodule is part benign and part malignant; it is more that the results on dependent on the size of the sample and the ability of the radiologist. The second type of biopsy is a video assisted thoracoscopic biopsy which involves going to the OR and you are put to sleep. The thoracic surgeon then makes two holes in the chest way and used the thoracoscopy (camera) to identify and then removed the nodule. Usually the whole nodule is removed and then sent for pathological review. This type of biopsy is always diagnostic and never inconclusive because the entire nodule is removed.
I hope this helps.
Susan Moffatt-Bruce, MD, PhD
Associate Professor of
Molecular, Virology, Immunology & Medical Genetics
College of Medicine
The Ohio State University