Definition

A needle biopsy of the lung or pleural is a procedure that allows doctors to use a needle to take a small sample of tissue so that it can be tested in the laboratory.

Female Torso with Respiratory System and Ribcage, Anterior View

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Parts of the Body Involved

  • Lungs
  • Pleura—The pleura is a slippery membrane that covers both the lungs and the chest wall.
  • Chest Cavity—The lungs are located in the chest cavity. This space is protected by the breastbone in the front of the body, and the spine in the back, as well as 12 pairs of ribs, which curve around the sides.

Reasons for Procedure

This procedure is used to diagnose abnormal tissue on the surface of the lung, in tissue surrounding the lung, or on the chest wall. Possible reasons for abnormal tissue are:

Needle biopsy is very accurate for diagnosing cancer.

Risk Factors for Complications During the Procedure

A needle biopsy should not be performed if you have the following:

  • Certain conditions associated with lung disease, such as bullae and cor pulmonale
  • Cysts
  • Problems with blood clotting
  • Severe hypoxia
  • Pulmonary hypertension
  • Need for mechanical ventilation

Also, tell your doctor if you are pregnant.

What to Expect

Prior to Procedure

  • In the days leading up to your procedure, do not start taking any new medications without consulting your doctor.
  • The night before, eat a light meal and don’t not eat or drink anything after midnight.
  • You may be given pre-procedure medications to prevent or account for certain conditions (e.g., to suppress a cough).
  • Before the procedure begins, you will be asked to sign a consent form.

Anesthesia

  • You may receive a mild sedative to help you relax about an hour before the procedure.
  • You may also have an injection of a local anesthetic, usually lidocaine, to numb the area where the needle will be inserted.

Description of the Procedure

Your skin is cleaned with an antiseptic solution. The procedure is done while you are awake and in a seated position, leaning forward, with your arms resting on a table for support. You should remain as still as possible and not cough.

The doctor makes a small cut in your skin. Then, while you hold your breath, a biopsy needle, which is a long hollow needle, is inserted through the cut. The needle is inserted between your ribs until it reaches the lung or pleura.

The location of the tissue to be tested must be determined. An imaging machine (usually ultrasound or CT) is used to help guide the needle to the exact spot. Your doctor then withdraws some cells through the biopsy needle.

After Procedure

  • Pressure is put on the site of the incision
  • When bleeding has stopped, a bandage is applied
  • A few hours after the procedure, a chest x-ray or other imaging technique is used to make sure a lung has not collapsed and that there is no bleeding

How Long Will It Take?

A typical procedure takes between 30 and 60 minutes.

Will It Hurt?

  • Before the procedure, when the local anesthetic is injected, you may feel a brief sting.
  • During the procedure, when the needle is inserted, you will probably feel some pressure. If you are having a lung biopsy, you will feel a quick, sharp pain when the needle touches your lung

Possible Complications

The biopsy is regarded as a safe procedure. It is seldom associated with any negative effects, but risks include:

  • Collapsed lung (pneumothorax)
  • Bleeding
  • Infection
  • Rarely, the needle can puncture the liver or spleen

Average Hospital Stay

  • After a lung or pleural biopsy, the recovery time is very short. You may rest for several hours after the procedure so that a nurse can check on you and monitor your recovery. If there are no complications after four hours, you may go home.
  • You are advised to rest at home for a day or two
  • Avoid strenuous activities for one week

Postoperative Care

You may remove the bandage after a day or two.

Outcome

Abnormal results could indicate:

  • Noncancerous tumors (eg, hamatoma or lipoma )
  • Cancer (eg, lung cancer, mesothelioma , or another cancer that metastasized to the lung)
  • Fibrosis (scarring of the lung tissue that occurs after exposure to certain irritants such as coal, asbestos or silica dust)
  • Pneumonia
  • Other infections (eg, tuberculosis or histoplasmosis)
  • Abnormal blood vessels in the lung (arteriovenous malformations, AVMs)
  • As a consequence of certain systemic diseases (eg, rheumatoid arthritis, sarcoidosis, or Wegener’s granulomatosis)

Call Your Doctor If Any of the Following Occurs

Contact your doctor immediately if you experience any of the following:

  • Bleeding
  • Shortness of breath
  • Fast heart beat
  • Bluish skin