Lung biopsy: special techniques.

Transthoracic needle biopsy of the indeterminate pulmonary nodule is a well-established, highly accurate, and minimally invasive diagnostic procedure. A pulmonary nodule in virtually any location is accessible to transthoracic needle biopsy. A solid understanding of special biopsy techniques enables the operator to overcome the commonly encountered challenges, including small, mobile, and partly obscured nodules. Because biopsy-related complications can be reduced but not completely eliminated, a familiarity with such complications and the procedures used to manage them is essential. A close partnership with the cytology team is crucial in achieving a high diagnostic accuracy during transthoracic needle biopsy. In the future, biopsy-derived microarray analysis may play a greater role in guiding treatment and predicting treatment outcomes.