title: Difficulties with CT-guided needle biopsy and VATS, as combined approach for the diagnosis and treatment of peripheral pulmonary nodules: a case report.
abstract: OBJECTIVE
  To re-evaluate the use of CT-guided needle biopsy and VATS, as our combined approach protocol for the diagnosis and treatment of peripheral pulmonary nodules.
  
  
  RESULTS
  We describe the case of a male smoking patient, 50-year-old, who came to our service for the histological diagnosis of a right pulmonary lesion incidentally revealed. He was submitted to our diagnostic and therapeutic protocol for peripheral pulmonary nodules, that is a combined approach of CT-guided needle biopsy, anchorage of the lesion and VATS resection. Difficulties with this technique can raise when: 1. the cytological CT-guided needle biopsy is not diagnostic, 2. the anchorage is not successful, 3. the malignancy of the lesion cannot be surely determined by the extemporary histological examination. In this patient all these difficulties were encountered.
  
  
  CONCLUSIONS
  We conclude that our diagnostic and therapeutic protocol for peripheral pulmonary nodules is not invalidated by this experience, even in consideration of the fact that we applied successfully the protocol in several previous cases.
authors.affiliation: Department of Surgical and Anesthesiological Sciences, University of Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Grazia
authors.forename: L
authors.initials: L
authors.lastname: Ansaloni
authors.forename: A
authors.initials: A
authors.lastname: Bini
authors.forename: G
authors.initials: G
authors.lastname: Grani
authors.forename: M
authors.initials: M
authors.lastname: Mastrorilli
authors.forename: D
authors.initials: D
authors.lastname: Pagani
authors.forename: F
authors.initials: F
authors.lastname: Sellitri
authors.forename: F
authors.initials: F
authors.lastname: Stella
authors.forename: R
authors.initials: R
authors.lastname: Bazzocchi
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000601:surgery; D001707:Biopsy, Needle; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014743:Videotape Recording