This 76-years old man had one episode of hemoptysis. CT scan shows an irregular lesion in the anterior segment of the right upper lobe, partly encasing the segmental bronchi and the vessels at the periphery.

The challenge in such cases is to be able to get into the lesion with minimal injury to the vessels and bronchi. It is also very important that the patient co-operates with a good shallow breathing rhythm and does not move.

This particular patient was extremely co-operative and it was possible to maneuver the needle into the lesion without bleeding or pneumothorax using a 20G coaxial biopsy gun. The diagnosis was adenocarcinoma.