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This review summarizes data of publications and meta-analyses devoted ton the use of transthoracic biopsy. It is showed that the method continues to be one of the main ways to diagnose pathological processes in the thoracic cavity's organs, especially tumors of the lungs, pleura, mediastinum and chest wall. Modern methods of navigation trepan-needles can receive sufficient volume of pathological tissue samples for subsequent full morphological study to individualize and optimize treatment algorithms.

Optimal extent of surgery for lung cancer is determined to a great degree by lymph drainage and regional metastases vis-a-vis tumor localization in the lobes. Data on surgical treatment of 505 cases of cancer of the lower lobe are presented. The study established such peculiarities of metastatic spread to mediastinal lymph collector as relatively frequent involvement of the lower mediastinal lymph nodes ("jumping" metastases included) and greater likelihood of spread to the superior mediastinal lymph nodes when those of radix pulmonis are involved. The latter should be interpreted as an indicator of lower lobe involvement. We established the significance of relatively worse prognosis for mediastinal lymph node involvement as well as high frequency of intrasternal recurrences of tumors located in the left lung. The prevailing evidence on partial resections of the right lung rather than lower bilobectomy and the good results of bilobectomies for stage T1-3N1-2 tumors suggest that conservative treatment might offer more advantage in managing cancer of the lower lobe of the right lung. Extended surgery entails lower incidence of intrasternal recurrence and is more effective when used to treat right-lung tumors.

The dynamics of growth of skin melanoma metastases to the lung versus chemoimmunotherapy regime has been assessed quantitatively. Natural course of such pathology at advanced stages was found to correspond to the exponent. An analytical procedure for plotting graphs was suggested, which will allow to estimate the kinetic characteristics of tumor growth. This in turn can be used as an indicator of therapy efficacy.

An analysis of the clinical and X-ray data on 2,107 cases of morphologically-confirmed lung cancer showed a relationship between roentgenologic and histologic patterns of both central and peripheral forms of the lesion. Main roentgenologic symptoms versus histologic pattern of both forms of lung cancer are discussed.

Based on the clinico-morphological estimation of scannograms, performed by means of sodium selenite--selenium-75, chloromercury-197 and gallium citrate-67 in 231 patients with tumor (185) and nontumor (46) lung diseases, it was found that the best results were obtained in scannographic visualization of primary tumors of the lung (87%). Positive scintigraphy was found to be of high diagnostic value in recognition of lung cancer proceeding against the background of atelectasis, inflammatory processes and other "disguises" hampering the clinico-roentgenological diagnosis. Positive scintigraphy may be employed in establishing the differential diagnosis between malignant and benign lung tumors.

Transthoracic needle biopsy was performed in 134 patients with peripheral coin lesions of the lung. The mentioned technic is very valuable diagnostically and enables the precise diagnosis to be established in the vast majority of patients with coin lesions of the lung in the shortest time possible. Transthoracic needle biopsy, when performed properly, is not a hazardous procedure, that makes it possible to recommend this technic for diagnosing peripheral coin lesions of the lung.

The analysis of the case reports of 116 patients with oat-cell cancer of the lung, treated at the N. N. Petrov Research Institute of Oncology of the USSR Ministry of Health from 1952 to 1971, has revealed some features of the clinico-roentgenological picture of the disease: a short-term anamnesis, prompt development of the symptoms with predominant pains in the involved thoraic portion and retorsternally, a prevailing peribronchial growth (76.6%), early and extensive metastasization revealed in 84.5% of cases. The detection, on roentgenograms and tomograms of the chest organs, of the block of enlarged lymph nodes in the lung hilus and mediastinum in the presence of a small tumor in the lung allowed oat-cell cancer to be suspected. The roentgenological picture of median oat-cell cancer is characterized by the presence of tumor conglomerate in the lung hilus, which consisted of the primary tumor penetrating in lymph nodes adjacent to the bronchus in 66.6% of canses.

A study of 115 lung cancer patients has shown that indications to the use of multi-modality gammascintigraphy or its separate variants are as follows: the presence of the clinical manifestations of distant metastases, data on a considerable local dissemination of a primary tumor to the lungs, poor differentiation by the histological structure.