The many facets of diagnostic bronchoscopy for pulmonary ground glass nodules

The recent years have witnessed a paradigm shift in the detection and management of pulmonary nodules, especially with regard to developments in imaging and biopsy modalities (1). Several investigators have demonstrated the use of three basic approaches for the diagnosis of peripheral pulmonary lesions: surgical, transbronchial, and transthoracic (2). The recent use of image guidance has particularly improved the yield of transbronchial biopsy (TBB) for pulmonary lesions, including those in the peripheral subsegments (3-5).