title: [Invasive procedure for clarification of pulmonary nodules].
abstract: OBJECTIVE
  The management of solitary lung nodules poses a common clinical problem and biopsy is oftten required. Several guidelines provide slightly different recommendations and there are no uniform recommendations regarding the ideal technique of puncture guidance (e.g. percutaneous versus bronchoscopic or thoracoscopic).
  
  
  METHODS
  Fine needle aspiration biopsy (FNA) and core biopsy are well established techniques. Both can be performed under CT and to some extent ultrasound guidance.
  
  
  METHODS
  Diagnostic accuracies of FNA and core biopsy for malignant lesions are around 95 %. Core biopsy is superior to FNA for establishing a specific diagnosis with a diagnostic yield of 81-88 % versus 17-21 %.
  
  
  RESULTS
  In clinical routine practice core biopsy is the superior tool when compared to FNA.
  
  
  CONCLUSIONS
  Central lesions in close proximity to bronchi may be biopsied with endobronchial ultrasound (EBUS)-guided bronchoscopy. In all other lesions percutaneous, ideally CT-guided biopsy should be the method of first choice.
authors.affiliation: Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Philipps-Universität Marburg, Baldingerstr., 35043, Marburg, Deutschland, mahnken@med.uni-marburg.de.
authors.forename: A H
authors.initials: AH
authors.lastname: Mahnken
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008175:Lung Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000473:pathology*
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