Diagnostic approach to pulmonary nodules in the postpneumonectomy patient.

摘要

The postpneumonectomy patient with an indeterminate pulmonary nodule in the contralateral lung represents a formidable diagnostic and therapeutic challenge. The diagnosis of suspicious peripheral lung nodules is performed most commonly by computed tomography (CT)- guided transthoracic needle aspiration (TTNA). Depending on the size and location, the diagnostic accuracy of TTNA ranges from 65%-96%.1 The TTNA-associated risk of pneu-mothorax, particularly in patients with emphysema, is 21%-40%, depending on the number of needle passes and the experience of the operator.Many interventional radiologists consider a previous pneu-monectomy as a contraindication to TTNA because of the significant risk of pneumothorax. In one published report, TTNA in postpeumonectomy patients was performed with a thoracic surgeon directly standing by for potential emergent tube thoracos-tomy. We propose a safe diagnostic technique with therapeutic potential for postpeumonectomy patients with indeterminate pulmonary nodules.