This is a 71-years old man with a nodule in the posterior segment of the left upper lobe. Funnily, it showed a spiculated aggressive appearance only on the sagittal image.

The question here is how to approach this lesion. While both the anterior oblique and posterior approaches are possible, the shortest distance to the nodule is the lateral decubitus position.

At the first instance, in the right lateral decubitus position, the scapula was in the way. Pushing the arm in front did not help, but after shifting the arm behind, a space opened up and the biopsy was then easy to do, with no pneumothorax. A 20-G coaxial biopsy gun was used.

The diagnosis was adenocarcinoma.
#CTbiopsy #lungbiopsy #lungcancer #adenocarcinoma #lungnodule