Investigations done before the biopsy procedure-

Before the biopsy is performed, it is important to thoroughly evaluate the patient for-

• Concomitant medication / illness

• Any drug allergy
• Past history of bleeding / clotting problems
• Pregnant status- Biopsy should not be performed in pregnant women
• Any primary lung diseases (cor pulmonale)

Biopsy is contraindicated in a patient with bullae (enlarged alveoli associated with emphysema), cysts, severe hypoxia (insufficient concentration of oxygen in blood) or pulmonary hypertension.

Tests commonly done before a biopsy procedure are:

• Routine blood investigations
• Platelet count is commonly done to check if the individual’s bleeding and clotting parameters are within normal limits. For those with counts lower than 50,000/cubic mm, a platelet transfusion would be required before the biopsy.
• Chest X-ray - To locate the exact biopsy site
• An arterial blood gas and a pulmonary function test may also be done.

Patient preparation before the biopsy-

• The patient is asked to avoid aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or blood thinners such as warfarin for a week before the procedure.
• Patient consent for the procedure is obtained.
• The patient should be on nil oral for a period of 12 hours before the biopsy.
• Sometimes, medications may be prescribed to dry up secretions in the mouth and airways.
• The patient is asked not cough during the biopsy procedure.
• The patient may be intubated to allow proper breathing during the biopsy procedure.
• Local anesthesia is injected into the site of the biopsy.
• The patient is asked to sit in a relaxed position with arms resting forward on a table. The biopsy is performed using a suitable procedure. Pressure is placed over the site after the biopsy procedure. A chest x-ray is taken after the biopsy. The results are obtained after a few days.