This is a 52-years old lady operated for thymoma. She presented with left sided chest pain and a PET/CT showed subpulmonic nodules on the left. Dry pleural metastases are known with thymomas and a biopsy was performed using a 20G coaxial biopsy gun in the right lateral decubitus position.

The decubitus position helps with breath-control and in this case also allowed easier and simpler access to the lesion.

The diagnosis was recurrence of thymoma.