Correct!
4. Transthoracic needle biopsy
Percutaneous transthoracic needle biopsy is the most appropriate choice. The lesion does not arise from the lung and is very peripherally located, and therefore a bronchoscopic approach is not likely to be rewarding. Both open resection and video-assisted thoracoscopic surgical biopsy would be capable of establishing a diagnosis but are needlessly aggressive at this point. 18FDG-PET scan may prove useful in this patient’s evaluation at some point, particularly if malignancy is established, but at this juncture neither increased not absent glucose utilization within the lesion will later management.
Then patient underwent ultrasound-guided transthoracic needle biopsy (Figure 5) of the left posterior inferior thoracic lesion.
Figure 5. Ultrasound of the left posterior inferior thoracic mass shows the lesion to have mixed echogenicity, predominantly hypoechoic, without through sound transmission to suggest cystic change, and showing some internal vascularity. The final image shows the needle placed within the lesion during transthoracic percutaneous biopsy.
Which of the following findings at biopsy would be inconsistent with the imaging appearance? (Click on the correct answer to be directed to the tenth and final page)