One case of percutaneous lung biopsy assisted by artificial pneumothorax technique and literature review.

RATIONALE: Early lung cancer diagnosis is crucial for prognosis, but elderly patients with comorbidities poorly tolerate invasive procedures. Conventional percutaneous biopsy for major vessel-adjacent high-risk nodules has a mere 60% to 70% success rate and high complications, while artificial pneumothorax boosts it to 85% to 90%. This case verifies the technique's safety in this population. PATIENT CONCERNS: A 72-year-old female had a 7-mm left lung ground-glass nodule (2021, no intervention). Follow-up computed tomography (CT) (November 2024) showed the nodule enlarged to 10 × 10 mm with a new 18 × 17 mm irregular consolidation. Empirical anti-infection failed; the lesion was adjacent to the aortic arch and heart, so artificial pneumothorax-assisted CT-guided biopsy was adopted. DIAGNOSES: Video-assisted thoracoscopic surgery confirmed stage IA1 (tumor, node, metastasis stage T1aN0M0) lung adenocarcinoma (lepidic-predominant + invasive mucinous subtypes), with negative margins and no vascular, nerve, or pleural invasion. INTERVENTIONS: CT-guided artificial pneumothorax-assisted percutaneous lung biopsy, followed by video-assisted thoracoscopic surgery left upper lobectomy plus lymph node dissection. OUTCOMES: Vital signs were stable; drainage tube removed on day 4 post-biopsy. One-month follow-up: no hemoptysis, chest pain, or pneumothorax; CT showed no intrapulmonary exudation. LESSONS: The technique is safe for lesions adjacent to the heart and major vessels. However, large-sample studies and artificial intelligence-based nodule analysis are needed to further verify its efficacy.