A lung needle biopsy is used to gather a piece of lung tissue for testing and examination. It is often used to diagnose an irregular area of tissue in or around the lungs. The technique is also called percutaneous needle aspiration.
Your doctor may perform a lung needle biopsy to investigate an abnormality found on a chest X-ray or computed tomography (CT) scan. The goal is to accurately diagnose whether you have cancer or another lung disease. This procedure can also be used to:
- monitor the progression of lung disease
- stage a malignant (cancerous) lung tumor
- identify the cause of inflammation in the lung
- explain why fluid has collected in the lung
- determine whether a lung mass is malignant or benign
- diagnose a lung infection
A lung needle biopsy may be performed on its own. It can also be done as part of other tests, such as:
- bronchoscopy, where a scope is used to look inside your lungs
- mediastinoscopy, a procedure used to see inside the chest
The first step of a lung needle biopsy is identifying the spot that needs to be tested. This is usually done with a chest X-ray or a CT scan. A healthcare provider will mark your chest where the sample needs to be taken.
During the biopsy, you will sit on an exam table. Your arms should rest by your sides.
Your skin will be cleaned. Then you will be injected with an anesthetic to numb the area. This may sting.
A small incision, or cut, will be made in the skin. The biopsy needle will be inserted. Your doctor will use it to take samples of the abnormal tissue. This may feel like pressure or even sharp pain.
Try to remain still and avoid coughing during the biopsy. When your doctor is ready to remove a tissue sample, you will need to hold your breath. Several samples may be needed.
Once the biopsy is done, the needle will be removed. Pressure will be applied to the insertion site. When the bleeding has stopped, the site will be bandaged. Sometimes a stitch is required to keep the opening closed while it heals.
The tissue samples will be sent to a laboratory for testing.
A typical lung needle biopsy lasts 30 to 60 minutes. You may not get your results back for several days.
Risks of a lung needle biopsy include:
- blood clots
- drainage and/or swelling at the biopsy site
- pain at the biopsy site
As with any surgical procedure, there is a small risk of excessive bleeding. While some bleeding is common, a large amount can become life threatening. Your doctor and other healthcare providers will monitor your bleeding during the biopsy.
Immediately after a lung needle biopsy is completed, you will undergo a chest X-ray or CT scan. This will check for a collapsed lung (pneumothorax). Rarely, a lung needle biopsy can cause a pneumothorax. Your risk for developing the condition increases if you have a lung disease such as emphysema.
A pneumothorax can become life threatening. Air can escape from the lung and become trapped in the chest. There, the air can press on the lungs and other nearby organs, such the heart. If this happens, you may need to have a chest tube inserted. It will reduce the pressure and help expand the collapsed lung.
Someone from the hospital should call the day before the procedure to confirm the time and location. Do not eat for at least 6 hours before the procedure. Your doctor may ask that you not eat after midnight the day before your biopsy.
Tell your doctor about all medications you are taking. Include both over-the-counter and prescription pills. Your doctor may ask you to stop taking certain drugs before the procedure. Some medications can make the biopsy less safe.
Unless your doctor says otherwise, you should avoid taking the following drugs for at least a week before the biopsy:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- blood thinners such as warfarin (Coumadin)
Before your biopsy, your doctor may administer a mild sedative through an intravenous (IV) line. This will help you relax.
You may be able to leave the hospital or clinic as soon as the biopsy is complete and any bleeding has stopped. If you were sedated, it may take up to a day to recover from the medication. You may also be asked to remain in the hospital so that your recovery can be monitored.
Before surgery, ask your doctor if you will be sent home that day. If so, plan to have a friend or relative drive you home. They should also stay with you to make sure you don’t have any complications. Talk to your doctor about how long you should rest before returning to work or school.
You may need some mild pain relievers to manage discomfort following the biopsy. Avoid aspirin and NSAIDs. They may increase your risk of bleeding. Take a nonaspirin pain reliever such as acetaminophen (Tylenol) instead. Your doctor may also prescribe a mild pain reliever.
Call your doctor if you have any of the following symptoms after your biopsy:
- blue-tinted skin
- chest pain
- coughing up blood
- difficulty breathing
- difficulty swallowing
- rapid heart rate
- redness or drainage around the biopsy site
- shortness of breath
- weakness in your legs