Hilar mass---? PET CT guided FNACi

[angelabarnes]

I am 51 yrs old prior history of kidney malig, post R nephrectomy 2003 and resected solitary lung  metastatic nodule Feb 2007 .
Am well  with slight dry cough , recently noted PET CT  positive  PET  avid  L hilar mass ( SUV 5.4 ) near the old nodule removal surgery staple site .
No History of smoking .

I live in India which is a high TB prone area . I have no fever , no sputum  mild dry cough only .

Have been suggested a CT guided FNAC . Is this a feasible procedure and safe for a hilar region  and will there be adequate yield for diagnosis . Who does this procedure ---Thoracic surgeon ? Radiologist or Pulmonologist  or should I go for Trans bronchial Biopsy ???

Any suggestions ?? Thank You

[HeinrikMD]

Hi,

The feasibility of the FNA would depend on the proximity of the nodule to either the chest wall or to a large airway. If it is near the chest wall, the needle would puncture through the chest and this could be done with either a CT or an ultrasound guide. The persons who perform this may be the pulmonologist, in other places an interventional radiologist. If the nodule is nearer a large airway then it can be approached via bronchoscopy, the transbronchial biopsy could be the better option (this would usually be done by the pulmonologist).