A paravertebral approach for CT-guided percutaneous biopsy of presumably inaccessible, posterior and centrally located pulmonary nodules

Katharina Martini; Guillaume Chassagnon; Souhail Bennani; Marie-Pierre Revel

doi:10.1016/j.radcr.2020.06.004

A paravertebral approach for CT-guided percutaneous biopsy of presumably inaccessible, posterior and centrally located pulmonary nodules

Radiol Case Rep. 2020 Jun 27;15(8):1377-1380. doi: 10.1016/j.radcr.2020.06.004. eCollection 2020 Aug.

Authors

Katharina Martini¹, Guillaume Chassagnon¹, Souhail Bennani¹, Marie-Pierre Revel¹

Affiliation

¹ Radiology department, Hôpital Cochin, APHP.Centre, Université de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, France.

Abstract

Introduction: To present 3 cases were a paravertebral approach had to be used for the biopsy of posterior and centrally located pulmonary nodules. Case presentation: Three patients underwent percutaneous CT-guided transthoracic biopsy of pulmonary nodules that were initially thought to be inaccessible because of their central, posterior location by a paravertebral approach. The first 2 patients had a history of extra thoracic malignancy and the third patient presented with a bone metastasis and an isolated pulmonary nodule in the right lower lobe, corresponding to potential stage IV lung cancer. Biopsy was feasible in all 3 patients using the paravertebral approach. Pulmonary metastases were confirmed in the first 2 patients, while a TTF-1 positive pulmonary adenocarcinoma was diagnosed in the last patient. No complications occurred. Conclusion: A paravertebral approach is feasible for posterior and centrally located pulmonary nodules.

Keywords: Lung cancer; Paravertebral biopsy; Pulmonary nodule biopsy.

Publication types

Case Reports