Cervical approach for percutaneous needle biopsy of Pancoast tumors

Aspiration needle biopsy techniques have simplified the cytohistological diagnosis of peripheral pulmonary lesions, particularly those close to or involving the chest wall. In the past, the inaccessibility of some Pancoast tumors in the thoracic inlet posed difficulty in obtaining histological proof before combined therapy was instituted, except in the case of large apical tumors. A safe and accurate technique for percutaneous needle biopsy of tumors in the superior pulmonary sulcus using a cervical approach has been developed. We have found that this technique is easy to perform and more productive for small or shallow lesions at the extreme apex than are needle biopsies performed through a posterior approach, and that it makes open biopsy unnecessary.