Pleural biopsy can be performed via which approaches?

Pleural biopsy can be performed via which approaches?

• A. Percutaneous needle
• B. VATS
• C. Open thoracotomy
• D. All of the above

Answer: (D)

Obtaining pleural tissue can be done through multiple approaches, chosen based on what is most accessible and safe for the patient. A percutaneous needle biopsy, guided by ultrasound or CT, is the least invasive option and works well when imaging shows focal pleural thickening or localized disease; it’s quick and can often diagnose without an incision, though it carries risks like pneumothorax and may yield smaller samples. Video-assisted thoracoscopic surgery (VATS) provides direct visualization of the pleural space, allows multiple targeted biopsies from several sites, and can be paired with concurrent procedures such as pleurodesis or decortication if needed. Open thoracotomy offers the widest exposure, enabling large or numerous samples and thorough assessment of the pleural surfaces, which is particularly helpful when malignancy is suspected diffusely or prior biopsies are nondiagnostic, albeit with greater morbidity. Because each method is a valid way to obtain diagnostic pleural tissue depending on the clinical scenario, the best answer is that all of these approaches can be used for pleural biopsy.

Obtaining pleural tissue can be done through multiple approaches, chosen based on what is most accessible and safe for the patient. A percutaneous needle biopsy, guided by ultrasound or CT, is the least invasive option and works well when imaging shows focal pleural thickening or localized disease; it’s quick and can often diagnose without an incision, though it carries risks like pneumothorax and may yield smaller samples. Video-assisted thoracoscopic surgery (VATS) provides direct visualization of the pleural space, allows multiple targeted biopsies from several sites, and can be paired with concurrent procedures such as pleurodesis or decortication if needed. Open thoracotomy offers the widest exposure, enabling large or numerous samples and thorough assessment of the pleural surfaces, which is particularly helpful when malignancy is suspected diffusely or prior biopsies are nondiagnostic, albeit with greater morbidity.

Because each method is a valid way to obtain diagnostic pleural tissue depending on the clinical scenario, the best answer is that all of these approaches can be used for pleural biopsy.