Biopsy techniques in the investigation of diseases of the lung, mediastinum, and chest wall.

Closed biopsy techniques are available for the investigation of diseases of the mediastinum, hilus, and chest wall as well as for pulmonary and pleural disease. Biopsy via the bronchoscope is of greatest value in the diagnosis of endobronchial lesions, especially those that are centrally sited, and of diffuse pulmonary disease including opportunistic infections. Fluoroscopically controlled fiberoptic bronchoscopy is beginning to replace the transcatheter biopsy technique. In general, the use of large needles for biopsy should be avoided. Percutaneous fine needle biopsy is an effective means of sampling lesions of the mediastinum, hilus, and chest wall. However, this mode of biopsy is most widely used as a safe and highly accurate means of diagnosing localized pulmonary disease.