Lung Biopsy – All You Need To Know

Medically Reviewed by Dr. K on 5 April 2021

What to Expect From a Lung Biopsy

A lung biopsy may be requested if your doctor notices something suspicious on your chest X-ray or CT scan. A doctor takes a small sample of cells from the lung and examines it under a microscope for evidence of cancer during this procedure.

A lung biopsy can also be done to assess the origin of the fluid in your lungs or to detect cancer.   The type of lung biopsy the doctor suggests will determine how to prepare.

Bronchoscopy (Transbronchial Biopsy)

A flexible tube about the width of a pencil is inserted into your mouth or nose and then guided into your lungs. A light and a camera assistant in the navigation of tiny devices that collect cells from the lung through the tube.

You'll be awake through this, so you'll be given medicine by IV to help you relax, as well as oxygen via a mask or nose tube.

Your doctor may use an X-ray to decide the best place for the biopsy. They'll then spray the numbing medication into your throat.

You may feel uncomfortable in your throat after the tube is inserted, and you won't be able to swallow, however, you will be able to breathe. You may get a sore throat, cough, or hoarseness when it's over, but it should go away in a couple of days.

Lung Needle Biopsy (Transthoracic Biopsy)

When a bronchoscopy fails to reach cells, you’ll need this sort of lung biopsy. A needle is inserted between two ribs in your chest by your doctor to get a sample from the outer area of your lungs.

You’ll be awake with numb skin, and you may be given a sedative to help you relax. An ultrasound, CT scan, or a special type of X-ray such as fluoroscopy may be used to determine the best location for the procedure.

You may experience pain or pressure when the needle reaches your lung. You’ll have to avoid coughing and maybe hold your breath.

Thoracoscopic Lung Biopsy (Thoracoscopy)

Your doctor may refer to this procedure as video-assisted thoracoscopic surgery (VATS). It examines the outside of your lungs for complications.

This procedure will be done under general anesthesia, which ensures you will not be conscious during it. A breathing tube is inserted into your mouth and into your lungs, and your doctor monitors your breathing, blood pressure, oxygen levels, and heart rate.

The doctor makes two to three minor cuts between your ribs on your chest, then inserts a narrow, lighted tube with a camera and takes out a sample of cells with small tools.

Open Lung Biopsy (Limited Thoracotomy)

When other methods fail to collect cell samples, the doctor would typically recommend this type of biopsy.

You will not be awake for this procedure, unlike in a thoracoscopic lung biopsy. Your doctor can make a larger cut than for most approaches, which may extend from your chest to your back, going across your arms and under your arms. It allows your doctor to be able to reach the lungs and remove the cells.

How to Prepare for Your Lung Biopsy

A full physical exam and blood tests may be required by your doctor to ensure that a lung biopsy is safe. Tell them whether you’re expecting a baby or if you have any allergies, such as to latex or medications. Also tell them whether you are taking any medications, especially aspirin or other blood-thinning medications.

You’ll be asked to sign consent forms. To fully comprehend the procedure and risks, read them carefully.

Inquire with your doctor about what you should anticipate during the operation. Consider the following points when you consider your options:

You’ll recover faster if you get a bronchoscopy or a needle biopsy. However, doctors remove fewer cells than in other procedures, rendering diagnosis more complicated in some situations.

You can have a sample of cells tested immediately if you’re doing a thoracoscopy or an open biopsy. Your doctor can remove more samples, or even an entire lung, during the same procedure, depending on the results.

You should avoid eating and drinking at least 8 hours before your lung biopsy, which is normally around midnight. You will be able to drink water in the morning if you are awake during the procedure.

What Happens After Your Biopsy?

Your lung biopsy sample will be sent to a lab for analysis, and you will get results in about a week.

A chest X-ray may be required to ensure that your lungs are in good working condition. In just a few hours, if you’re not asleep, you should be allowed to return home. It is not possible to travel, but have someone pick you up. Alternatively, you may have to spend one or two nights in the hospital.

Your chest may be painful for the next few days. If you have a wound from the procedure, disinfect it according to your doctor’s instructions. You may typically resume your daily activities, although you will need to refrain from intensive physical exercise for a few days. Just take pain relievers that the doctor has prescribed, although others, such as aspirin, may cause you to bleed more.

Risks and Complications

Both forms of lung biopsies carry the risk of pneumonia.

In these treatments, a pneumothorax (where air leaks out between the lung and the chest cavity) will make it difficult to breathe or cause the lung to collapse, so the doctor can have an eye on this and suck out air as needed.

Severe bleeding, wound infection, and blood clots are also potential risks of surgical lung biopsies.

If you notice any of the following signs of infection or complications, contact your doctor:

  • A fever over 37.5 degrees Celsius
  • Redness, swelling, or blood or fluid leaking from the wound
  • Severe chest pain
  • Breathing difficulties
  • Coughing up blood or mucus laced with blood

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