A lung biopsy is a medical procedure that removes a small piece of lung tissue for microscopic examination. This provides detailed cellular information not available through imaging tests alone. Its primary purpose is to identify lung abnormalities and guide medical decisions.
Purposes of a Lung Biopsy
A lung biopsy investigates abnormalities found on imaging tests like X-rays or CT scans. It commonly diagnoses lung cancer, determining if suspicious growths are malignant or benign. The procedure also helps identify specific types of lung cancer for treatment planning. Beyond cancer, a lung biopsy aids in diagnosing non-cancerous lung conditions like interstitial lung diseases (e.g., pulmonary fibrosis, sarcoidosis). It can also pinpoint the cause of lung infections (bacterial, fungal, or viral) when standard tests are inconclusive, and help understand why fluid accumulates in the lungs.
Types of Lung Biopsy Procedures
Several methods perform a lung biopsy, chosen based on the abnormality’s location and the patient’s overall health. Each technique safely obtains a tissue sample for analysis.
Bronchoscopic Biopsy (Transbronchial Biopsy)
A bronchoscopic biopsy (transbronchial biopsy) involves inserting a thin, flexible bronchoscope through the mouth or nose into the airways. The bronchoscope has a camera, allowing visualization. Tiny tools, such as forceps, pass through it to collect tissue samples from the lung, often through the bronchial wall. This procedure takes 30 minutes to an hour and uses local anesthesia and sedation.
Needle Biopsy (Percutaneous Needle Biopsy or Transthoracic Needle Biopsy)
A needle biopsy (percutaneous or transthoracic) involves inserting a hollow needle through the chest wall into the lung. This method is used for abnormalities closer to the lung’s outer areas or chest wall. Imaging guidance, such as CT or ultrasound, directs the needle to the target. The procedure uses local anesthetic, with the patient awake.
Surgical Biopsy
Surgical biopsies are invasive procedures requiring incisions to access the lung directly. They are chosen when less invasive methods cannot provide a sufficient tissue sample, allowing for larger specimens.
Video-Assisted Thoracoscopic Surgery (VATS) Biopsy
Video-Assisted Thoracoscopic Surgery (VATS) biopsy is a minimally invasive technique. It uses one to three small chest incisions for a thoracoscope (camera tube) and surgical instruments. The camera transmits images to a screen, allowing the surgeon to view the lung and remove tissue samples. VATS offers reduced pain and quicker recovery than open surgery.
Open Lung Biopsy
An open lung biopsy is a traditional surgical procedure requiring a larger chest incision. This provides direct visibility and access to the lung. Performed under general anesthesia, it is necessary for larger tissue samples, especially when other methods fail or a suspicious area needs complete removal.
After the Biopsy
After a lung biopsy, patients are monitored for complications like bleeding or lung function issues. Recovery time varies; some go home in hours, others stay overnight. Soreness at the biopsy site is common for a few days.
The tissue sample goes to a pathology laboratory for microscopic examination by a pathologist. The pathologist identifies abnormal cells, infections, or diseases. Results are typically available within three to five working days, though specialized tests may take longer. The referring doctor discusses findings with the patient to determine next steps.