Ultrasound-guided transthoracic forceps biopsy of a peripheral lung mass

Interventional pulmonologists are often called upon to diagnose a variety of intrathoracic abnormalities. Linear array endobronchial ultrasound has greatly increased the diagnostic accuracy of transbronchial needle aspiration for centrally located lesions in the chest, and radial endobronchial ultrasound and electromagnetic navigation have markedly increased the diagnostic yield for biopsies of peripheral pulmonary lesions. Image-guided transthoracic biopsies of peripheral pulmonary lesions that approximate the pleural surface have been successfully performed using the "core" biopsy devices, though these may be less successful for smaller pleural-based lesions given their design. In this case study, we describe a novel technique for the biopsy of a peripheral lung mass using ultrasound guidance and biopsy forceps.