Lung biopsy can be performed by various methods, which are described below:Bronchoscopic biopsy-
Bronchoscopic biopsy is used for collecting abnormal lung tissues present near the breathing tubes (bronchi).
A flexible bronchoscope is inserted through the mouth or nose to reach the lungs from where the lung tissue sample is collected.
It is a non-invasive procedure compared to open lung biopsy and usually takes between 30 and 60 minutes.
After the procedure, the patient may develop a sore throat and hoarseness. This can be treated with salt water gargling. The patient may feel a bitter taste and difficulty in swallowing due to the anesthesia. Some patients may develop fever, which usually subsides within 24 hours.Needle biopsy procedure-
Needle biopsy procedure is used to obtain abnormal lung tissues which are located close to the chest wall.
The patient is given a sedative about an hour before the biopsy in order to relax the patient.
The biopsy site is marked with small metal markers. The skin is then cleansed with an antiseptic solution and a local anesthetic is injected over the incision site to numb the area.
Before inserting the needle into the lung, a small superficial incision is made on the biopsy site; the patient is then asked to take a deep breath and hold it till the needle is inserted into the lung under ultrasound or fluoroscopy guidance. During the insertion of the needle, one may experience a sharp pain or burning sensation for a few seconds.
After collection of the required biopsy material, the needle is removed and pressure is applied at the biopsy site. Bleeding is avoided by applying a bandage over the puncture site.
Needle lung biopsy procedure may take about 30 to 60 minutes.
Patients are advised to rest at home for a day or two before resuming regular activities, and to avoid strenuous activities for a week after the biopsy.
Lung collapse may occur because of air that leaks in through the hole made by the biopsy needle. In such conditions, a tube is inserted in the chest to remove the air. CT-guided needle lung biopsy
CT-guided needle lung biopsy involves monitoring of the biopsy procedure by a computerized tomography (CT) scan of the chest.
The patient is not supposed to drink or eat for 8 hours prior to the procedure.
The procedure is done as an outpatient procedure by giving a local anesthesia. The patient can be discharged within 4 to 5 hours after the procedure and does not require any hospitalization.
Rarely, patients may develop lung collapse after the procedure. Therefore, a chest x-ray is taken 3 to 4 hours after the biopsy procedure. Open biopsy
Open biopsy is done as an outpatient procedure.
The biopsy involves removing part or all of the lump or area of interest. If the entire lump is removed, this method may also be called a lumpectomy.
A breast ultrasound, MRI, or mammogram may be used to find the growth if the surgeon cannot easily feel the lump or cyst. A needle or wire is placed in the area during the imaging test to help the surgeon find the growth.Mediastinoscopy with biopsy-
A mediastinoscope is inserted in the space in the chest between the lungs (mediastinum), and tissue is collected from any unusual growth or lymph nodes.
The patient is given general anesthesia before the procedure. An endotracheal tube is placed in the nose or mouth to help the patient breathe.
A small incision is taken in the neck. The mediastinoscope is inserted through this incision and gently passed into the mid-part of the chest.
Tissue samples of the growth or lymph nodes are taken and the scope is then removed. The incision is closed with sutures.
A chest x-ray is usually taken at the end of the procedure.
The procedure usually takes 60 - 90 minutes. Video-assisted thoracoscopic surgery (VATS)-
VATS is a recently developed surgery that enables doctors to view the inside of the chest cavity after making only very small incisions.
It allows surgeons to remove masses close to the outside edges of the lung.
It is also useful for diagnosing certain pneumonia infections or tumors of the chest wall, and treating repeatedly collapsing lungs.