Lung Biopsy: How It Is Done

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How It Is Done

You may be given some medications before the biopsy to dry up the secretions in your mouth and airways.

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, wigs, makeup, and jewelry 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.

Bronchoscope biopsy

A bronchoscope biopsy is done by a doctor who specializes in lung problems (pulmonologist). 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.

Needle biopsy

A needle biopsy is done by a doctor who specializes in X-ray tests (radiologist) or a pulmonologist. 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.

Open biopsy and video-assisted thorascopic surgery (VATS)

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 thorascope 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.

A chest X-ray is usually taken after a lung biopsy to look for any problems related to the biopsy.

Video-assisted thorascopic surgery (VATS) may not be available in your area. You may need to travel to a regional medical center for this test.

Last updated:	March 21, 2007
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Robert L. Cowie, MB, FCP(SA), MD, MSc, MFOM - Pulmonology
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer