Percutaneous lung biopsy: an ordering clinician's guide to current practice

The discovery of a pulmonary nodule or mass usually leads to a clinical assessment of patient risk factors for malignancy and an imaging workup. The latter may include appropriately timed follow-up, computed tomography with the possible addition of a computed tomographic nodule enhancement study, positron emission tomography, and/or percutaneous biopsy of the lung lesion or associated lymph nodes or metastatic lesions. This article reviews the rationale for the imaging workup of lung lesions and the details of percutaneous needle biopsy, including risks, technical feasibility, techniques, needle systems, cytological/pathological evaluation, accuracy, complications, and complication management.