Lung Biopsy

What are the types of lung biopsy procedures?

There are several types of lung biopsies, your doctor will determine which biopsy is most appropriate for your case by evaluating the type of lung problem you have, the location of the lesion and your overall health.

Transbronchial biopsy

Also known as a bronchoscopy, is performed when your doctor wants to examine the airways. During the procedure, your doctor will insert a bronchoscopy through the nose or mouth and thread it down to the lungs.

Lung needle biopsy

Also known as transthoracic lung biopsy, is an option for patients when the suspicious cells can’t be reached by a bronchoscopy. During a lung needle biopsy, your doctor will insert a needle into the chest to take a sample of tissue on the outer edges of the lungs.

Thoracoscopic biopsy

Also known as throascopy or video-assisted thoracoscopic surgery (VATS), checks for any disease or abnormalities on the outside of the lungs.

Open lung biopsy

Also known as limited thoracotomy, is an invasive type of lung biopsy that is typically only performed when your doctor can not get a tissue sample by any of the other methods.

Why do you need a lung biopsy?

You may need a lung biopsy to:

• Diagnose a lung infection
• Determine cause of fluid that is collecting in the lung
• Evaluate if a tumor in the lung is cancerous or noncancerous
• Determine cancer stage of malignant (cancerous) tumors
• When your doctor detects something abnormal on your chest x-ray or CT scan.

If you are pregnant, please consult with your doctor prior to the lung biopsy.

What are the risks associated with a lung biopsy?

Lung biopsies are typically performed using an x-ray machine, so you will be exposed to minimal doses of radiation. In most patients, the exposure to radiation does not cause any side effects.

Risks associated with a lung biopsy will differ depending upon the type of lung biopsy you are having.

Complications associated with a thoracoscopic lung biopsy, also known as an open lung biopsy include:

• Blood clots
• Bleeding
• Pain
• Infection at surgical site
• Pneumonia

Complications associated with a transbronchial lung biopsy, also known as a needle lung biopsy, include:

• Bleeding in the lung
• Infection at the needle insertion site
• Trouble breathing
• Low oxygen levels
• Lung collapse — if air becomes trapped in the pleural space
• Heart attack
• Pneumonia

Contact your Mercy Health care team if you develop a high fever, if you have blood or fluid leaking from the wound, or you are experiencing severe chest pain, shortness of breath or you are coughing up blood or bloody mucus.

What to expect during a lung biopsy

What you can expect during a lung biopsy will differ based on the type of lung biopsy you are having and whether the procedure is closed or open.

Bronchoscopy

A bronchoscopy is a closed procedure that lasts approximately 30 minutes. During the procedure, your doctor will insert a bronchoscope into the nose and thread it down to the bronchi. Once in the correct location, brushes or needles attached to the end of the bronchoscope begin collecting lung tissue samples. In some patients, your doctor may spray a saline solution onto the bronchi to wash off cells on the surface of the lungs. The cells are then collected and evaluated in a lab under a microscope.

As your doctor evaluates the cells, he or she may find blood, mucus, infection, swelling, a tumor or a blockage in the airways. If your doctor finds a blockage, you may need a stent to keep the airways open.

Lung needle biopsy

You will be awake during a lung needle biopsy. Your doctor will numb the area and give you a sedative. You will need to have an ultrasound, CT scan or fluoroscopy to determine the most appropriate place for the procedure. When the location has been established, your doctor will insert a needle into the lung to collect tissue for evaluation in the laboratory.

Thoracoscopy

During a thoracoscopic lung biopsy, you will be given general anesthesia to put you to sleep. Your care team will insert a breathing tube down your throat and thread it down to the lungs. Your blood pressure, breathing, oxygen levels and heart rate will be closely monitored by your nurses and care team during the entire procedure.

Once you are properly sedated, your doctor will make three cuts between the ribs on your chest and insert a tube with a camera on it in the space. When in position, your doctor will take a sample of tissue or fluid to be examined in the laboratory.

Open lung biopsy

Because of the complexity of the procedure, you will be given a general anesthesia to put you to sleep for an open lung biopsy. Your surgeon will make a large incision that may run from your chest to your back. The large incision will allow your doctor to easily access the lungs and remove tissue to evaluate in a laboratory.

Recovery from a lung biopsy

You will recover quicker after a closed lung biopsy procedure than you will if you have an open lung biopsy procedure. For all procedures, your doctor will take a chest x-ray before you are discharged to ensure your lungs are working properly. Your care team will also closely monitor your recovery to ensure your breathing and blood pressure are stabilized before you are discharged. You will be instructed not to eat or drink anything for approximately two hours or until your throat does not feel numb any longer. Because of the anesthesia, you will need to have someone drive you home from the hospital.

Once you are home, your chest may be sore for up to a couple weeks. It is important to avoid any intense physical activity and closely follow your doctor’s discharge instructions on pain management and wound healing.

Results from a lung biopsy

Your tissue samples will be sent to a laboratory for evaluation under a microscope. Your doctor will receive the results within a week and will schedule an appointment to review them with you.