The Choice of lung biopsy method in the presence of limited focal lesions

<b>Aim:</b> to еvaluate the possibility of historical transthoracic needle under CT-navigation (THBL) and transbronchial biopsy (TBL) to verify the etiology of focal lesions of the lungs. <b>Material and Methods:</b> two randomized groups of patients (50) with limited focal lung lesions, the etiology of which could not be clarified by non-invasive diagnostic methods. THBL with the area of the biopsy under CT was performed on 20(group 1), TBL with the material sampling of the 2nd segment of the right lung was performed on 30(group 2). The biopsy material in the form of 1-2 columns of tissue 1-2 mm in diameter and a length of 1-2 mmby patients of the 1st group and 2-4 fragments diameter of 3 mm by patients of the 2nd group was subjected to a complex histological and molecular genetic (DNA search of M. tuberculosis). <b>Results:</b> Pathologically altered lung tissue was obtained in 85% in the 1st group and 56.3% in the 2nd group (p&lt;0.05), in other cases unchanged lung tissue was obtained. Pathological changes in the form of caseified EC granulomas were detected in 61.7% of cases, in 38.3% there were non-caseified EC granulomas and giant Pirogov–Lanhgans cells, which in combination with clinical signs and the results of PCR analysis allowed to diagnose disseminated tuberculosis and sarcoidosis, respectively. In patients of the group 2, the results of PCR analysis were unreliable due to contamination of the biopsy during its extraction. Complications in the form of limited traumatic pneumothorax (the 2nd and 1st case, respectively) did not require additional interventions. <b>Conclusion:</b> THBL under CT navigation is the method of choice for verification-focal lesions of the lungs.