Minimally invasive techniques for the diagnosis of peripheral pulmonary nodules.

PURPOSE OF REVIEW: Evaluation and management of patients with pulmonary nodules continue to be a significant clinical challenge due to the possibility of malignancy.

RECENT FINDINGS: With advances in technology, several minimally invasive diagnostic options are available for diagnosis of peripheral pulmonary lesions. Development and refinement of minimally invasive sampling techniques will aid in clinical decision making, as well as help advance scientific understanding of lung cancer growth and metastasis.

SUMMARY: Although most surgical candidates should be referred promptly for resection, transthoracic or bronchoscopic biopsy may be particularly helpful when an infectious cause is suspected, when the patient is a marginal or poor candidate for surgery, or when a surgical candidate desires proof of malignancy before proceeding to surgery. Newer minimally invasive techniques should be rigorously evaluated for their role in the diagnostic algorithm of peripheral lung lesions.