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A lung biopsy removes a small piece of lung tissue which can be looked at under a microscope. The biopsy can be done in four ways. The method used depends on where the sample will be taken from and your overall health.
A lung biopsy is done to:
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of the biopsy, fill out the medical test information form .
Before you have a lung biopsy, tell your doctor if you:
Your doctor may order certain blood tests, such as a complete blood count (CBC) and clotting factors, before your lung biopsy.
Your doctor will tell you how soon before the biopsy to stop eating and drinking. Follow the instructions exactly about when to stop eating and drinking, or your surgery may be cancelled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.
Arrange to have someone drive you home after the procedure if you do not need to stay in the hospital.
A needle or bronchoscope biopsy can be done without staying in the hospital. An open biopsy requires a hospital stay for at least a few days.
You may be asked to remove dentures, eyeglasses or contact lenses, hearing aids, a wig, makeup, and jewellery before the biopsy. You will empty your bladder before the biopsy. You will need to take off all or most of your clothes (you may be allowed to keep on your underwear if it does not interfere with the biopsy). You will be given a cloth or paper covering to use during the biopsy.
A bronchoscopic biopsy is done by a doctor who specializes in lung problems (respirologist). It is usually done using a thin, flexible bronchoscope. In rare cases, a biopsy may be done using a rigid bronchoscope.
Bronchoscopy usually takes between 30 and 60 minutes. You will be in the recovery room 1 to 2 hours. A chest X-ray is usually taken after a lung biopsy to look for any problems related to the biopsy.
A needle biopsy is done by a doctor who specializes in X-ray tests (radiologist) or a respirologist. Your doctor will use a CT scan, ultrasound, or fluoroscopy to guide the biopsy needle. The place where your doctor inserts the needle is cleaned first with an antiseptic solution and draped with sterile towels. Your doctor will give you a local anesthetic to keep you from feeling any pain when the needle is inserted into your chest.
Your doctor will then make a small puncture and ask you to hold your breath while the biopsy needle is inserted into your lung. It is very important to avoid coughing or moving while the needle is in your chest.
Once the desired amount of tissue is collected, the needle is removed and a bandage is placed over the puncture site. You will need to lie on your side for at least an hour to allow the needle puncture site to seal up.
This biopsy takes about 30 to 60 minutes. You will be in the recovery room 1 to 2 hours. A chest X-ray is usually taken after a lung biopsy to look for any problems related to the biopsy.
An open biopsy is done by a chest (thoracic) surgeon or a general surgeon. You will be given a general anesthetic by an anesthesiologist. There may also be one or more assistants in the room.
You will be given a sedative to help you relax about an hour before the biopsy. You will have an intravenous line (IV) placed in a vein. A tube will be placed in your windpipe (trachea) and a machine will help you breathe.
An incision is made between the ribs over the area of lung where the tissue sample is to be collected. A scope called a thoracoscope may be passed through this incision to view the surface of the lung and to remove a sample of lung tissue. A larger incision will be made if an open biopsy is needed to remove a tissue sample.
After the tissue sample is collected, your doctor will insert a drainage tube (chest tube) into the area and close the incision with stitches. One end of the tube will be in the space next to your lung and the other end will be sticking out of your chest and connected to a collection container. The chest tube helps re-expand your lung. The chest tubes will be removed when the drainage from your chest has stopped and no air is leaking from your chest incision, usually in a few days. Your stitches will be removed in 7 to 14 days.
The entire biopsy usually takes about an hour. After the lung biopsy is done, you will be taken to the recovery room for about an hour. You will then be taken to your hospital room.
Recovery from a video-assisted thoracoscopic surgery (VATS) takes less time than from an open biopsy surgery.
A chest X-ray is usually taken after a lung biopsy to look for any problems related to the biopsy.
Video-assisted thoracoscopic surgery (VATS) may not be available in your area. You may need to travel to a regional medical centre for this test.
The local anesthetic used in your mouth or nose generally tastes bitter and may make you choke. Your mouth may feel very dry for several hours after the biopsy. You may also have a sore throat and some hoarseness for a few hours. Sucking on throat lozenges or gargling with warm salt water may help your sore throat.
The anesthesia may make it hard to swallow. You may need to avoid eating or drinking for at least an hour after the procedure.
You may have a mild fever shortly after the biopsy, which usually goes away within 24 hours. If it does not, call your doctor.
When you are given the shot to freeze your skin at the needle biopsy site, you will feel a sharp stinging or burning sensation that lasts a few seconds. When the needle is inserted into the chest, you will again feel a sharp pain for a few seconds. The radiologist may ask you to hold your breath for a few seconds at different times during the biopsy.
The sedative will make you feel sleepy and relaxed. You will be asleep during the biopsy because of the general anesthetic.
After the biopsy, you may feel tired for 1 or 2 days or have general muscle aches. You may also have a mild sore throat from the tube that was placed in your throat to help you breathe. Sucking on throat lozenges or gargling with warm salt water may help your sore throat.
You may feel some discomfort at the biopsy site when you take a deep breath. The incision may itch as it is healing. Your doctor will give you pain medicine.
A bandage will be placed over the biopsy site. You may be advised to keep the biopsy site covered and dry for 48 hours. You may have a small amount of bleeding from the biopsy site. Ask your doctor how much bleeding to expect.
A lung biopsy is generally a safe procedure. Any risk depends on if you have a lung disease and how severe it is. If you already have severe breathing problems, your breathing may be worse for a short time after the biopsy.
Bronchoscopic and needle biopsies are usually safer than open or VATS biopsies, but the VATS and open biopsies are more likely to allow a good sample of lung to be removed. A good sample helps determine what the lung problem is and what treatment choices are. Bronchoscope or needle biopsies do not need general anesthesia, cause fewer problems, and you do not need to stay overnight in the hospital. Your doctor will discuss any risks with you.
After a lung biopsy, call your doctor immediately if you have:
Call your doctor if you have a fever.
A lung biopsy removes a small piece of lung tissue which can be looked at under a microscope.
Lung biopsy results are usually available in 2 to 4 working days. It may take several weeks to get results from tissue samples that are being tested for certain infections, such as tuberculosis.
The lung tissue is normal under a microscope. No signs of infection, inflammation, or cancer are present.
Abnormal cells and tissue in the lung may be due to active infection, certain lung diseases, or several different types of cancer. If lung cancer is present, results of the biopsy can determine treatment options (surgery, radiation, or chemotherapy).
A biopsy sample that is too small for a diagnosis can affect the accuracy of the results.
A needle biopsy collects tissue from such a small area that there is a chance that a cancer may be missed.
Other Works ConsultedPagana KD, Pagana TJ (2014). Mosby's Manual of Diagnostic and Laboratory Tests, 5th ed. St. Louis: Mosby.
Current as of: February 24, 2020
Author: Healthwise StaffMedical Review: Adam Husney MD - Family MedicineAnne C. Poinier MD - Internal MedicineE. Gregory Thompson MD - Internal MedicineRobert L. Cowie MB, FCP(SA), MD, MSc, MFOM - PulmonologyDavid C. Stuesse MD - Cardiac and Thoracic Surgery
Current as of: February 24, 2020
Author: Healthwise Staff
Medical Review:Adam Husney MD - Family Medicine & Anne C. Poinier MD - Internal Medicine & E. Gregory Thompson MD - Internal Medicine & Robert L. Cowie MB, FCP(SA), MD, MSc, MFOM - Pulmonology & David C. Stuesse MD - Cardiac and Thoracic Surgery
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