Biopsy Techniques in the Diagnosis of Intrathoracic Lesions

Including Lung Biopsy, Mediastinal Biopsy and Resection of the Deep Cervical Fat Pad and Its Contained Nodes Report of 12 Illustrative Cases

¹ Chief of the Surgical Service and Head of the Department of Thoracic Surgery, United States Naval Hospital, St. Albans, Long Island, New York, The United States Naval Hospital, St. Albans, Long Island, New York.
² The United States Naval Hospital, St. Albans, Long Island, New York.

1) Ideal therapy of intrathoracic lesions cannot be undertaken without an accurate histological diagnosis.

2) The role of bronchoscopic and esophagoscopic biopsy in the investigation of thoracic lesions has long been firmly established and the necessity for early exploratory thoracotomy in the management of undiagnosed unilateral solid pulmonary infiltrates suspected of representing bronchogenic carcinoma has been widely accepted in recent years.

3) There are other biopsy techniques available for the study of intrathoracic disease that do not appear to have been generally utilized. These include: (a) Resection of the deep cervical fat pad and its contained nodes, (b) mediastinal biopsy at open thoracotomy and (C) lung biopsy at open thoracotomy. We have used each of these methods in an appreciable series of cases and in practically every instance it has been possible to establish a definite histological diagnosis. The procedures have occasioned minimal morbidity and no mortality. They appear to merit more widespread use in the investigation of chest lesions posing difficult diagnostic problems.

4) Cases are reported to illustrate the use of each of the three foregoing methods.