Needle Biopsy of the Lung and Pleura Overview

A needle biopsy of the lung or pleura is done to remove a sample of lung or pleural tissue or fluid. Pleura is the lining of the lungs and chest wall. Once the tissue is removed, it will be examined in a lab.

Female Torso with Respiratory System and Ribcage, Anterior View © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

Your doctor may order:

• A complete physical exam
• X-ray —a test that uses radiation to take a picture of structures inside the body
• CT scan —a type of x-ray that uses a computer to make pictures of the inside of the body
• Ultrasound—uses sound waves to make pictures of the inside of the body
• Blood tests

Leading up to your procedure, do not start taking any new medicines without consulting your doctor.

You may be given pre-procedure medicines for certain conditions (eg, to suppress a cough).

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

Anesthesia

• You may receive a mild sedative about an hour before the procedure. It will help you relax.

• You may also have an injection of a local anesthetic. It will numb the area where the needle will be inserted.

Description of the Procedure

Your skin will be cleaned with an antiseptic solution. You will be in a seated position, leaning forward, with your arms resting on a table for support. You should remain as still as possible. An ultrasound or CT scan will be used to locate the exact spot to be biopsied.

A small cut will be made in your skin. Then, while you hold your breath, the biopsy needle will be inserted through the cut. The needle will be passed between your ribs until it reaches the lung or pleura. Your doctor then withdraws some cells through the biopsy needle. The needle will be withdrawn. Pressure will be put on the site of the incision. When the bleeding stops, a bandage will be applied.

How Long Will It Take?

Between 30-60 minutes

How Much 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.

Post-procedure Care

At the Care Center

• You may rest for several hours after the procedure. A nurse will check on you and monitor your recovery.

• A few hours after the procedure, a chest x-ray or other imaging technique may be done. This is done to make sure a lung has not collapsed and that there is no bleeding.

• If there are no complications after four hours, you may go home.

At Home

When you return home, do the following to help ensure a smooth recovery:

• Rest at home for a day or two.
• Avoid strenuous activities for one week.
• You may remove the bandage after a day or two.
• Be sure to follow your doctor's instructions .

Ask your doctor when to expect the results of the biopsy.

RESOURCES:

American Cancer Society
http://www.cancer.org/

American Lung Association
http://www.lungusa.org/

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca/

Canadian Lung Association
http://www.lung.ca/

References:

Beers MH, Fletcher AJ, Jones TV, et al. The Merck Manual of Medical Information: Second Home Edition. Whitehouse Station, NJ: Merck Research Laboratories; 2003.

Busick NP, Fretz PC, Galvin JR, et al. Transthoracic needle aspiration biopsy. Virtual Hospital website. Available at: http://www.vh.org . Accessed September 6, 2005.

Light R, Lee G (eds). Textbook of Pleural Diseases. London, England: Arnold; 2003.

Mason RJ. Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, PA: WB Saunders; 2005.

Murray JF, Mason RJ. Murray & Nadel’s Textbook of Respiratory Medicine. 4th ed. Philadelphia, PA: Saunders, 2007.

Ost D, et al. Clinical practice. The solitary pulmonary nodule. N Engl J Med. 2003;348:2535.