[Endoscopy of peripheral lung nodule]

Pulmonary nodules of unknown dignity, often incidental findings, still present a diagnostic challenge. Next to operative resection, we find minimal invasive therapies such as transthoracal punctions and bronchoscopy with transbronchial as further options. By using modern navigation techniques, the validity of bronchoscopy in diagnosing pulmonary nodules, compared to x-ray fluoroscopy, has already been improved. Thus, the use of endobronchial ultrasound, electromagnetic navigation and virtual bronchoscopy--even without x-ray fluoroscopy--is possible and the combination augments sensitivity. These techniques already rate high in patients with unclear peripheral pulmonary nodules and high risk profiles to surgical operations, thus not to be operated, but still in need of further diagnostic procedures in order to plan therapy options. A future use of endoscopic therapies may possibly be a first approach.