Alternate Names: Biopsy - lung needle

How Performed: A chest X-ray is often used to identify the area to be biopsied. You are asked to sit with your arms resting forward on a table. You should maintain this position and refrain from coughing during the biopsy. The skin is scrubbed and a local anesthetic is injected. A small (about 1/8-inch) incision may be made in the skin, and the biopsy needle is inserted into the abnormal tissue, tumor, or lung tissue. A small specimen is removed with the needle and sent to the laboratory. Pressure is placed over the site. Once bleeding has stopped, a bandage is applied. A chest X-ray is obtained immediately after the biopsy. The procedure usually takes 30 to 60 minutes; laboratory analysis usually takes a few days.

How To Prepare: Before a needle biopsy of the lung, a chest X-ray, CT scan of the chest, or bronchoscopy has been performed. Sometimes a mild sedative will precede the biopsy. You must sign a consent form. It is important to remain as still as possible for the biopsy and to refrain from coughing.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child’s age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child’s age:

• infant test or procedure preparation (birth to 1 year)
• toddler test or procedure preparation (1 to 3 years)
• preschooler test or procedure preparation (3 to 6 years)
• schoolage test or procedure preparation (6 to 12 years)
• adolescent test or procedure preparation (12 to 18 years)

How It Feels: A lung needle biopsy is preceded by a local injection of anesthetic, which will sting for a moment. You will feel pressure and a brief, sharp pain when the needle touches the lung.

Risks: The risks include infection, bleeding, and pneumothorax (a collapsed lung). A needle biopsy should not be performed if other tests indicate the presence of bullae (enlarged alveoli associated with emphysema), cysts, blood coagulation disorder of any type, hypoxia (insufficient blood oxygenation), pulmonary hypertension, or cor pulmonale (enlargement of the right ventricle secondary to pulmonary hypertension that results from primary lung diseases - a type of heart failure).

Why Performed: A needle lung biopsy is performed when there is an abnormal condition that is near the surface of the lung, in the lung parenchyma (the tissues surrounding the lungs), or on the chest wall. The test can be performed to obtain a sample for culture when infection of the lung is suspected and sputum or bronchoalveolar lavage cultures have not identified the cause of the infection.

Normal Values: Normal tissues and no microbial growth if a culture is performed are normal.

Abnormal Results:

• bacterial, viral, or fungal lung infection (for example, cytomegalovirus)
• pneumonia
• cancerous cells (lung cancer)
• immunoglobulin deposits (IgG, or rarely IgA) in the lung alveolar basement membranes (indicating immune disorders)

• cryptococcosis
• diffuse interstitial pulmonary fibrosis
• Goodpasture’s syndrome
• idiopathic diffuse interstitial pulmonary fibrosis
• metastatic cancer to the lung
• pneumonia with lung abscess
• pulmonary alveolar proteinosis

Cost:

Special Considerations: Signs of pneumothorax include shortness of breath, rapid heart rate (pulse), blueness of the skin (late sign). If any of these occur, report them to the health care provider immediately.