A lung needle biopsy is a procedure to obtain a very small sample of lung tissue. The tissue is then examined with a microscope.
This technique is used to diagnose an irregular area of tissue in your lungs. A needle biopsy is also called percutaneous needle aspiration.
Your doctor can use this procedure to:
- determine whether a lung mass is benign (noncancerous) or malignant (cancerous)
- stage a malignant lung tumor
- monitor the progression of lung disease
- identify the cause of inflammation in your lung
- explain why fluid has collected in your lung
- diagnose a lung infection
A lung needle biopsy may be performed on its own or with other tests, such as:
- Bronchoscopy. In a bronchoscopy, an instrument with a camera on its end is inserted into your throat through your mouth, and then into the airways in your lungs. This allows your doctor to view various parts of your lungs.
- Mediastinoscopy. In a mediastinoscopy, an instrument with a light is inserted through an incision in your chest. Your doctor uses the mediastinoscope to view the area between your lungs. Afterward, they collect lymph node tissue for testing.
Make sure you tell your doctor whether you’re pregnant, you may be pregnant, or you’ve had a recent illness.
Also tell your doctor about all of the medications you’re taking, both over the counter and prescription. You may be told to avoid taking some medications for a period of time before your procedure, including:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB) and aspirin
- some blood thinners, such as warfarin (Coumadin)
Someone from the facility where you’ll have the biopsy will call you before the procedure to confirm the time and location. You may be told to avoid eating or drinking for at least 6 to 8 hours before the biopsy.
A specialist known as an interventional radiologist usually performs the biopsy with the aid of a CT or other type of scan.
Before the biopsy
The radiologist indicates the exact spot where the needle should be placed by drawing on your skin with a marker.
You may have an intravenous line inserted into a vein in one of your arms or hands. This is used to deliver a sedative to make you sleepy.
A technician or nurse helps you get into the correct position. They clean the skin over the biopsy site with an antiseptic. Then they inject you with an anesthetic to numb the area. This may sting.
During the biopsy
Your radiologist will generally use a biopsy needle that’s several inches in length. The design of the needle — hollow and wider than those used for regular shots — is what allows them to obtain a tissue sample.
A tiny incision may be made in your skin to allow for easy insertion of the biopsy needle. How much of the needle is inserted depends on the location of abnormal lung tissue. Your radiologist then takes samples of the abnormal tissue. This may feel like pressure or even sharp pain.
You’ll be asked to remain still and avoid coughing during the biopsy. When your radiologist is ready to remove a tissue sample, you’ll need to hold your breath. Several samples may be required.
After the biopsy
Once the biopsy is done, the needle is removed. Pressure is applied to the insertion site to help control any bleeding. When the bleeding has stopped, the site is bandaged. Sometimes one or more stitches are required if an incision is made. A typical lung needle biopsy is usually completed in less than 60 minutes.
The tissue samples will be sent to a laboratory for testing.
Lung needle biopsies are usually safe. However, as with any procedure, there are risks. For a lung needle biopsy, these include:
Immediately after the biopsy, the technicians and nurses will monitor you for signs of any complications. You may be able to leave the facility shortly after your biopsy is complete.
Talk to your doctor about how long you should rest before returning to work or school. Also ask about any restrictions, such as lifting or heavy exercise.
If you were sedated
If you were sedated, it may take a day or so to recover from the medication. In this case, plan to have a friend or relative drive you home. Once you’re home, they should also stay with you until you’re fully awake.
If you’re in pain
You may need some pain medication to manage discomfort following the biopsy.
Avoid NSAIDs, as they may increase your risk of bleeding. Take a nonaspirin pain reliever such as acetaminophen (Tylenol) instead.
Your doctor may also order a prescription pain reliever.
When to call your doctor
You may cough up a small amount of blood. If this concerns you, call your doctor.
Also call your doctor if you have any of the following symptoms after your biopsy:
- bleeding from the biopsy site
- redness or drainage at the biopsy site
- coughing up more than a small amount of blood
- difficulty breathing
- chest pain
Once the tissue samples are examined, a report will be sent to your doctor, who will contact you with the results. They may receive the report quickly, or it may take a few days. Results are typically ready in 2 or 3 days, though.
Depending on the findings, your doctor may order additional tests. Once they determine a diagnosis, they may suggest a treatment plan or refer you to other specialists.