The recent changes to lung adenocarcinoma classification and the emergence of "personalised" cancer therapy have presented significant challenges for respiratory physicians. For decades, lung cancer treatment was based on the dichotomy of “small” or “non-small” cells in the biopsy sample, a distinction that could be made from very few tumour cells.

As a result of the advances in molecular analysis and development of targeted therapies, tissue requirements have markedly increased, forcing respiratory physicians to reconsider how they collect and handle small volume biopsies in order to provide the pathologist with sufficient high quality material to enable histological and molecular subtyping.

This talk will discuss the various methods used to biopsy lung masses and address the growing discrepancy between sample size (small bronchial biopsy and cytology specimens) provided by bronchoscopists and tissue volume requested by pathologists and oncologists.