Advanced Bronchoscopic Techniques for Diagnosis of Peripheral Pulmonary Lesions

I. Introduction The number of newly diagnosed lung cancers will be greater than 200,000 in 2008 (1). As many as 25% to 30% of these will present as peripheral lesion (2). When a peripheral lesion is initially identified, the pretest probability of lung cancer should be assessed. This estimate of the probability of lung cancer being present should be based on a careful history, physical exam, and review of CT images. Factors to focus on include the lesion’s size, morphology, type of opacity, and growth rate (3). However, to confirm a diagnosis, a tissue biopsy will frequently be required.