A transthoracic needle aspiration (TTNA), which uses a long needle inserted through the chest wall, can sometimes be used to remove a tissue sample from an SPN. This usually is done if the abnormal lung tissue is located close to the chest wall. Imaging procedures such as CT scan, ultrasound, or fluoroscopy typically are used to help guide the needle to the right spot. Another possible test is bronchoscopy with transbronchial biopsy (TBB). In this test, a flexible tube is inserted through the nose and down to the lungs. A camera in the tube shows where the SPN is, and a tiny tool in the same tube takes a small sample of the SPN tissue.
Most cancerous nodules can be identified through biopsy, but positive identification of noncancerous nodules can still be difficult. If a biopsy shows cancer, surgery can often remove the cancer. If your doctor determines that you have a high risk of having a cancerous nodule, he or she may decide not to do this test and instead recommend surgery to remove the nodule. A pathologist looks at the nodule under a microscope to see if it is cancer.
Follow-up testing for a noncancerous SPN includes chest X-rays or CT scans as often as your doctor recommends to look for any change in the size or shape of the nodule.