Table 1 Criteria to evaluate the feasibility of biopsy for the progressive lesions
Feasibility of biopsy | Criteria |
|---|---|
Category A Accessible using conventional techniques | Lung nodules of long diameter ≥ 2 cm and positive CT bronchus signa for TBB Pulmonary infiltration (lymphangitis) for TBLB |
Intrapulmonary lesions of long diameter ≥ 1 cm and ≤5 cm distant from the thoracic wall for CTNB | |
Hilar or mediastinal lymph node (#2, 4, 7, 8, 10, 11, 12) enlargement with a long diameter ≥ 1 cm for EBUS-TBNA (EUS-FNA) | |
Pleural effusion with a mean thickness ≥ 1 cm on chest CT image for thoracentesis | |
Peripheral lymph node or cutaneous lesions of long diameter ≥ 2 cm for needle biopsy Bone metastasis with invasion to surrounding soft tissue for CTNB | |
Category B Invasive or difficult (but possible) to biopsy | Lung nodules of long diameter 1 ≤ and <2 cm with positive CT bronchus sign for TBB |
Intrapulmonary lesions of long diameter < 1 cm and ≤5 cm distant from the thoracic wall, or lesions of long diameter ≥ 1 cm and >5 cm distant from the thoracic wall for CTNB Hilar or mediastinal lymph node #2, 4, 7, 8, 10, 11, 12) enlargement of long diameter < 1 cm for EBUS-TBNA (EUS-FNA) | |
Pleural effusion with mean thickness < 1 cm on chest CT image for thoracentesis | |
Intra-abdominal lesions (including hepatic or adrenal metastases) of long diameter ≥ 2 cm for CTNB Peripheral lymph node or cutaneous lesions of long diameter < 2 cm for needle biopsy | |
Category C Extremely difficult to biopsy or highly invasive | Lung nodules of long diameter < 1 cm or negative CT bronchus for TBB Intrapulmonary lesions of long diameter < 1 cm and >5 cm distant from the thoracic wall for CTNB Mediastinal lymph node accessible only by surgical mediastinoscopy or thoracoscopy Intra-osseous lesions (bone metastasis) Intracranial lesions and meningeal carcinomatosis Any lesions anatomically accessible only by surgical procedures |