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In the present day, small solitary pulmonary cancer is detected to a great extent from lung cancer screening programs using low dose computed tomography (CT) scans. The smaller the nodules are, the more challenging tissue biopsies are. Non-subpleural, peripheral pulmonary nodules are the most difficult areas to obtain a tissue biopsy. In patients who failed CT Guided biopsy or Electromagnetic Navigation Bronchoscopy (ENB) with biopsy, Video Assisted Thoracic Surgery (VATS) with biopsy under dye marking can be performed to make a definite diagnosis. We report a case where we performed navigation bronchoscopy with dye marking for the first time in Thailand as a diagnosis option to offer this group of patients.
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