Transthoracic needle aspiration; Percutaneous needle aspiration
A lung needle biopsy is a method to remove a piece of lung tissue for examination. If it is done through the wall of your chest, it is called a transthoracic lung biopsy.
The procedure usually takes 30 to 60 minutes. The biopsy is done in the following way:
You should not eat for 6 to 12 hours before the test. Follow instructions about not taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, 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 medicines.
Before a needle biopsy of the lung, a chest x-ray or chest CT scan may be performed.
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 biopsy needle touches the lung.
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 check for cancer. The biopsy is usually done after abnormalities appear on a chest x-ray or CT scan. Sometimes your doctor might recommend a bronchoscopy instead of lung needle biopsy depending on the location of the abnormality.
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.
An abnormal result may be due to any of the following:
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, there is preexisting lung disease or it 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 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:
Signs of a collapsed lung include:
If any of these occur, call your provider right away.
Given MF, Clements W, Thomson KR, Lyon SM. Percutaneous biopsy and drainage of the lung, mediastinum, and pleura. In: Mauro MA, Murphy KPJ, Thomson KR, Venbrux AC, Morgan RA, eds. Image-Guided Interventions. 3rd ed. Philadelphia, PA: Elsevier; 2021:chap 103.
Walsh R, Klein JS. Thoracic radiology: invasive diagnostic imaging and image-guided interventions. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 21.BACK TO TOP
Review Date: 7/31/2022
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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