Lung Biopsy - Types, Uses, Instructions to Follow, and Risk Factors

Introduction

A biopsy is a procedure in which a small tissue is removed from the body to examine under a microscope. In lung biopsy, a small tissue from the lungs is removed to investigate lung diseases. The suspected tissue in the lungs is removed by the surgeon for diagnosis. The type of biopsy is chosen depending on the medical condition.

What Are the Types of Lung Biopsy Procedures?

The different types of lung biopsy are as follows;

• Open Biopsy: An incision is made on the chest to remove a piece of tissue or a lobe from the lungs. This incision helps the surgeon to visualize the ribs. Since the surgery is performed under general anesthesia, a urinary catheter is inserted to drain the urination. An instrument is used to hold the ribs apart. The tissue is removed and frozen for biopsy. The fluid and the air collected inside the chest cavity are removed simultaneously during the biopsy. A dressing is placed to avoid infection postoperatively.

• Needle Biopsy: This procedure involves a closed biopsy method. Needle biopsy is also called a transthoracic biopsy. After cleaning the operating area with an antiseptic solution, local anesthesia is given. An incision is made to insert the needle into the chest wall to collect the tissue. Hold your breath during the procedure. With the help of the computed tomography scan, the location of the tissue required for biopsy is found. The needle is then removed by applying pressure near the area of withdrawal. Once the bleeding stops, the suture is made to cover the area. A dressing is given, and the sample is sent for a biopsy report.

• Transbronchial Biopsy: The surgery is performed under general anesthesia along with the oxygen facemask. Medication is sprayed to create numbness in the throat. A fiberoptic bronchoscope is used to perform this procedure. It is a long and very delicate tube with a telescope at the end. It is inserted into the airways. The telescope is used to examine the bronchus and lungs. The sample is collected and sent to the lab for a biopsy report.

• Thoracoscopic Biopsy: Before performing a thoracoscopic biopsy, general anesthesia is given. During this procedure, the patient should face sidewards. An incision is made in the chest to insert the tools. The endoscope is used to enter the thoracic cavity. There are various tools in this procedure to collect lung tissue. This procedure is performed under video assistance. Any nodule or lesion, or tumor involving the lung lobe is removed with the help of video assistance. This procedure is called video-assisted thoracic surgery. The sample is frozen and sent to the biopsy.

What Are the Conditions That Require Lung Biopsy?

The lung biopsy is performed to diagnose the various lung diseases such as;

• It is used as a confirmatory test after evaluating the lungs using chest X-rays.

• Lung biopsy is used to determine the benign or malignant lesions in the lungs. The tumor stage and the extent can be determined with the help of a lung biopsy.

• It is used to assess the unwanted fluid collected in the lungs due to any respiratory infection. This medical condition is known as pneumonia.

• It is used to identify scarring in the lungs. This condition is called interstitial lung disease.

• It is used to analyze pulmonary fibrosis and determine the thickening of the walls in the lungs.

• The granulomas in the lungs lead to sarcoidosis. This can be determined by biopsy.

• A biopsy is used to analyze pneumoconiosis. It occurs due to the inflammation of the lungs by dust particles.

• A small portion of tissue from the lungs is removed to analyze the pulmonary-renal syndrome.

How to Prepare for Lung Biopsy?

• A consent form explaining the surgery will be provided before the operation. Read carefully and sign it.

• Ask any doubts regarding the procedure to the surgeon and follow the instructions given.

• A blood test is taken before the procedure to determine the bleeding disorders, red cell, and white cell count.

• The individual should not eat for eight hours before the lung biopsy. If local anesthesia is given, make sure to clear the liquids in the stomach before the procedure in the morning.

• Consult the medical professional if you are pregnant or planning for the same. Do not take any risks during pregnancy.

• The individual allergic to latex gloves or anesthesia must inform before the procedure.

• Inform the surgeon about the medications and supplements taken.

• Remove the jewelry and dress before the procedure. Wear a sterile gown before the surgery.

• The surgery is performed in a sitting or lying position along with an IV (intravenous) infusion.

• The heart rate and blood pressure are monitored during the surgery.

What Are the Risk Factors Involved in the Lung Biopsy?

• The chest X-rays are repeatedly taken after the surgery, and computed tomography is used to monitor the chest. This causes more radiation exposure.

• Since the bronchoscope is passed through the throat, it causes a gagging reflex and sore throat. It causes nausea and vomiting after the surgery.

• Internal bleeding in the lungs can occur in surgeries involving closed procedures.

• Holding their breath for a long time during the procedure is difficult for some patients.

• There may be blood loss during the thoracoscopic surgery since it is open surgery.

• Although the surgery is performed under general anesthesia, the patient has pain and discomfort after the surgery.

• Unsterile surgical methods can spread the infection to the lungs and other parts of the body. This bacterial infection causes blood clots in the lungs.

• There is a high risk of pneumonia due to the infection.

• During the transbronchial procedure, the air gets trapped in the pleural space causing pneumothorax, which eventually causes lung collapse.

How to Take Care After a Lung Biopsy?

• An X-ray is taken after the procedure to monitor the symptoms in the lungs.

• After the procedure, a tube is inserted into the chest to remove the air or fluid postoperatively.

• A suture is placed by the surgeon to close the incision.

• A dressing is given to keep the area sterile.

• Due to the insertion of the tube, the throat feels discomfort. It interferes with swallowing, and the patient feels difficulty eating. Medications like throat lozenges will be prescribed by the medical professional to soothe the throat.

• The anesthesia keeps the throat numb for a few hours. Do not eat or drink anything until recovery.

• Some patients have a gag reflex postoperatively. Gargle with warm salt water to prevent gagging.

• Do not cough more vigorously. There may be bloodstains in the cough. It is normal, and the patient can spit out in the basin. The caretaker will monitor the secretions.

• The bandage can be removed as per the instruction, and the patient can bathe as usual.

• The site where the biopsy is done is painful for several days. Pain killer is given to relieve the soreness in the site.

• Patients who intake Aspirin must report to the surgeon because it increases the bleeding. Continue the medication after surgery as per the instruction.

• Do not involve in vigorous physical activities after the procedure.

Conclusion

The recovery rate depends on the type of anesthesia before the procedure. The blood pressure and heart rate are monitored during and after the procedure to avoid any complications. The patient can stay overnight in the hospital and go home the next day. Do not drive after discharge from the hospital. Consider visiting the doctor if there is any breathing difficulty, blood discharge, chest pain, and bleeding in the operated site. The severity of the procedure depends on any existing systemic disease.