Lung Needle Biopsy

How to Prepare for the Test

You should not eat for 6 to 12 hours before the test. Follow instructions about not taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or blood thinners such as warfarin for a period of time before the procedure. Check with your health care provider before changing or stopping any medications.

Before a needle biopsy of the lung, a chest x-ray or chest CT scan may be performed.

How the Test will Feel

You will receive an injection of anesthetic before the biopsy. This injection will sting for a moment. You will feel pressure and a brief, sharp pain when the needle touches the lung.

Why the Test is Performed

A lung needle biopsy is done when there is an abnormal condition near the surface of the lung, in the lung itself, or on the chest wall. Most often, it is done to rule out cancer. The biopsy is usually done after abnormalities appear on a chest x-ray or CT scan.

Normal Results

In a normal test, the tissues are normal and there is no cancer or growth of bacteria, viruses, or fungi if a culture is performed.

What Abnormal Results Mean

• Bacterial, viral, or fungal lung infection
• Cancerous cells (lung cancer, mesothelioma)
• Pneumonia

Risks

Sometimes, a collapsed lung (pneumothorax) occurs after this test. A chest x-ray will be done to check for this. The risk is higher if you have certain lung diseases such as emphysema. Usually, a collapsed lung after a biopsy does not need treatment. But if the pneumothorax is large or does not improve, a chest tube is inserted to expand your lung.

In rare cases, pneumothorax can be life threatening if air escapes from the lung, gets trapped in the chest, and presses on the rest of your lungs or heart.

Whenever a biopsy is done, there is a risk of too much bleeding (hemorrhage). Some bleeding is common, and a health care provider will monitor the amount of bleeding. In rare cases, major and life-threatening bleeding can occur.

A needle biopsy should not be performed if other tests show that you have:

• Blood coagulation disorder of any type
• Bullae (enlarged alveoli that occur with emphysema)
• Cor pulmonale
• Cysts of the lung
• Pulmonary hypertension
• Severe hypoxia (low oxygen)

Considerations

Signs of a collapsed lung include:

• Blueness of the skin
• Chest pain
• Rapid heart rate (rapid pulse)
• Shortness of breath

If any of these occur, report them to your health care provider immediately.

References

Ettinger DS. Lung cancer and other pulmonary neoplasms. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 197.

Silvestri GA, Jett JR. Clinical aspects of lung cancer. In: Mason RJ, Broaddus CV, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 47.