Differential Diagnosis of Peripheral Lung Lesions: Capabilities and Limitations of Current Methods

This article analyzes 63 scientific works dedicated to the diagnosis of peripheral lung lesions (PLL). The differential diagnosis of PLL poses challenges due to the diversity of underlying pathologies, which may include tuberculoma, cancer, and benign tumors. The absence of a unified diagnostic algo...

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Main Authors: R. N. Islamov, R. A. Sharipov, M. A. Bagirov, R. K. Tukfatullin, G. V. Chitorelidze, E. V. Pavlova, R. K. Yagafarova
Format: Article
Language:English
Published: Bashkir State Medical University 2025-07-01
Series:Креативная хирургия и онкология
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Online Access:https://www.surgonco.ru/jour/article/view/1088
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author R. N. Islamov
R. A. Sharipov
M. A. Bagirov
R. K. Tukfatullin
G. V. Chitorelidze
E. V. Pavlova
R. K. Yagafarova
author_facet R. N. Islamov
R. A. Sharipov
M. A. Bagirov
R. K. Tukfatullin
G. V. Chitorelidze
E. V. Pavlova
R. K. Yagafarova
author_sort R. N. Islamov
collection DOAJ
description This article analyzes 63 scientific works dedicated to the diagnosis of peripheral lung lesions (PLL). The differential diagnosis of PLL poses challenges due to the diversity of underlying pathologies, which may include tuberculoma, cancer, and benign tumors. The absence of a unified diagnostic algorithm often necessitates surgical intervention. Non-invasive methods, including radiography, computed tomography (CT), positron emission tomography (PET), and sputum analysis, exhibit limited diagnostic yield, particularly for small lesions. The combination of fiberoptic bronchoscopy with endoscopic ultrasound (EUS) and transthoracic biopsy enhances diagnostic accuracy; however, they carry risks such as pneumothorax. Video-assisted thoracoscopic surgery (VATS) is an effective modality when biopsies are inconclusive, especially for lesions of less than 3 cm. It ensures high diagnostic accuracy and reduces hospitalization duration. Videoassisted thoracoscopic biopsy offers diagnostic accuracy comparable to that of open biopsy, while exhibiting reduced invasiveness. Conventional thoracotomy remains indicated for large or hard-to-reach lesions. It is recommended that a comprehensive approach combining CT, characterized by high informative value, and PET scan, characterized by high sensitivity and specificity for nodules >10 mm, with invasive methods be used. VATS proves effective for lesions below 3 cm, while thoracotomy is applied to large lesions. An individualized approach remains essential for optimal diagnosis. Despite the advancements, the challenge of differential diagnosis persists.
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spelling doaj-art-fe93865661464152b5acc207767e390f2025-08-20T03:57:27ZengBashkir State Medical UniversityКреативная хирургия и онкология2076-30932307-05012025-07-0115216017010.24060/2076-3093-2025-15-2-64-74625Differential Diagnosis of Peripheral Lung Lesions: Capabilities and Limitations of Current MethodsR. N. Islamov0R. A. Sharipov1M. A. Bagirov2R. K. Tukfatullin3G. V. Chitorelidze4E. V. Pavlova5R. K. Yagafarova6Bashkir State Medical University ; Republican Clinical Phthisiopulmonology CenterBashkir State Medical UniversityCentral Scientific Research Institute of Tuberculosis ; Russian Medical Academy of Postgraduate EducationBashkir State Medical UniversityCentral Scientific Research Institute of TuberculosisBashkir State Medical UniversityBashkir State Medical UniversityThis article analyzes 63 scientific works dedicated to the diagnosis of peripheral lung lesions (PLL). The differential diagnosis of PLL poses challenges due to the diversity of underlying pathologies, which may include tuberculoma, cancer, and benign tumors. The absence of a unified diagnostic algorithm often necessitates surgical intervention. Non-invasive methods, including radiography, computed tomography (CT), positron emission tomography (PET), and sputum analysis, exhibit limited diagnostic yield, particularly for small lesions. The combination of fiberoptic bronchoscopy with endoscopic ultrasound (EUS) and transthoracic biopsy enhances diagnostic accuracy; however, they carry risks such as pneumothorax. Video-assisted thoracoscopic surgery (VATS) is an effective modality when biopsies are inconclusive, especially for lesions of less than 3 cm. It ensures high diagnostic accuracy and reduces hospitalization duration. Videoassisted thoracoscopic biopsy offers diagnostic accuracy comparable to that of open biopsy, while exhibiting reduced invasiveness. Conventional thoracotomy remains indicated for large or hard-to-reach lesions. It is recommended that a comprehensive approach combining CT, characterized by high informative value, and PET scan, characterized by high sensitivity and specificity for nodules >10 mm, with invasive methods be used. VATS proves effective for lesions below 3 cm, while thoracotomy is applied to large lesions. An individualized approach remains essential for optimal diagnosis. Despite the advancements, the challenge of differential diagnosis persists.https://www.surgonco.ru/jour/article/view/1088lung neoplasmsvideo-assisted thoracoscopythoracotomytransthoracic biopsycomputed tomographydifferential diagnosisbronchoscopyradial endobronchial ultrasoundvideo-assisted thoracoscopic surgery
spellingShingle R. N. Islamov
R. A. Sharipov
M. A. Bagirov
R. K. Tukfatullin
G. V. Chitorelidze
E. V. Pavlova
R. K. Yagafarova
Differential Diagnosis of Peripheral Lung Lesions: Capabilities and Limitations of Current Methods
Креативная хирургия и онкология
lung neoplasms
video-assisted thoracoscopy
thoracotomy
transthoracic biopsy
computed tomography
differential diagnosis
bronchoscopy
radial endobronchial ultrasound
video-assisted thoracoscopic surgery
title Differential Diagnosis of Peripheral Lung Lesions: Capabilities and Limitations of Current Methods
title_full Differential Diagnosis of Peripheral Lung Lesions: Capabilities and Limitations of Current Methods
title_fullStr Differential Diagnosis of Peripheral Lung Lesions: Capabilities and Limitations of Current Methods
title_full_unstemmed Differential Diagnosis of Peripheral Lung Lesions: Capabilities and Limitations of Current Methods
title_short Differential Diagnosis of Peripheral Lung Lesions: Capabilities and Limitations of Current Methods
title_sort differential diagnosis of peripheral lung lesions capabilities and limitations of current methods
topic lung neoplasms
video-assisted thoracoscopy
thoracotomy
transthoracic biopsy
computed tomography
differential diagnosis
bronchoscopy
radial endobronchial ultrasound
video-assisted thoracoscopic surgery
url https://www.surgonco.ru/jour/article/view/1088
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