One of the more challenging tasks that a pulmonologist faces is the proper staging of a patient who is being evaluated for possible lung cancer. The role of bronchoscopy has been the standard procedure for providing the patient with a tissue diagnosis, as well as disease staging, using the least invasive method possible. Conventional bronchoscopy offers techniques to blindly biopsy peripheral nodes in the lungs as well as most mediastinal structures. Due to the visual limitations, more invasive procedures such as mediastinoscopy must sometimes be performed for complete evaluation.
The two main clinical situations that offer increased challenge for sampling and diagnosis are:
-peripheral lesions that are not visible on fluoroscopy.
-mediastinal or hilar lymph nodes that appear enlarged on CT scan but are difficult to locate using conventional bronchoscopy techniques.