Avoidance of negative percutaneous lung biopsy using contrast-enhanced CT.

Fluoroscopically guided percutaneous biopsy of pulmonary masses is an accepted procedure, but large neoplasms often have necrotic areas which, if aspirated, do not afford a pathologic diagnosis. Such tumors may require multiple punctures or procedures to establish a diagnosis. A prebiopsy contrast-enhanced CT scan selectively demonstrates the extent of peripherally located, viable tumor tissue. Three cases of initially frustrated lung biopsies in which viable, diagnostic tissue was localized for fluoroscopic aspiration using the contrast-enhanced CT scan are presented.