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Pleural needle biopsy
Closed pleural biopsy; Needle biopsy of the pleura
Pleural biopsy is a procedure to remove a sample of the tissue lining, the lungs, and the inside of the chest wall to check for disease or infection.
How the Test is Performed
This test may be done in the hospital. It may also be done at a clinic or doctor's office.
The procedure involves the following:
- During the procedure, you are sitting up.
- Your health care provider cleanses the skin at the biopsy site.
- Numbing drug (anesthetic) is injected through the skin and into the lining of the lungs and chest wall (pleural membrane).
-
A larger, hollow needle is then placed gently through the skin into the chest cavity. Sometimes, the provider uses
ultrasound
or
CT
imaging to guide the needle.
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
ImageRead Article Now Book Mark ArticleCT
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
ImageRead Article Now Book Mark Article -
A smaller cutting needle inside the hollow one is used to collect tissue samples. During this part of the procedure, you are asked to sing, hum, or say "eee." This helps prevent air from getting into the chest cavity, which can cause the lung to collapse (
pneumothorax
). Usually, 3 or more biopsy samples are taken.
Pneumothorax
A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung, between the lung and chest wall. This bui...
ImageRead Article Now Book Mark Article - When the test finished, a bandage is placed over the biopsy site.
In some cases, pleural biopsy is done using a fiberoptic scope. The scope allows the doctor to view the area of the pleura from which the biopsies are taken.
How to Prepare for the Test
You will have blood tests before the biopsy. You will likely have a chest x-ray .
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
How the Test will Feel
When the local anesthetic is injected, you may feel a brief prick (like when an intravenous line is placed) and a burning sensation. When the biopsy needle is inserted, you may feel pressure. As the needle is being removed, you may feel tugging.
Why the Test is Performed
Pleural biopsy is usually done to find the cause of a collection of fluid around the lung ( pleural effusion ) or other abnormality of the pleural membrane. Pleural biopsy can diagnose tuberculosis , cancer, and other diseases.
Pleural effusion
A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.
Tuberculosis
Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.
If this type of pleural biopsy is not enough to make a diagnosis, you may need a surgical biopsy of the pleura .
Surgical biopsy of the pleura
An open pleural biopsy is a procedure to remove and examine the tissue that lines the inside of the chest. This tissue is called the pleura....
Normal Results
Pleural tissues appear normal, without signs of inflammation, infection, or cancer.
What Abnormal Results Mean
Abnormal results may reveal cancer (including primary lung cancer , malignant mesothelioma , and metastatic pleural tumor ), tuberculosis, other infections, or collagen vascular disease.
Primary lung cancer
Small cell lung cancer (SCLC) is a fast-growing type of lung cancer. It spreads much more quickly than non-small cell lung cancer. There are two typ...
Malignant mesothelioma
Malignant mesothelioma is an uncommon cancerous tumor. It mainly affects the lining of the lung and chest cavity (pleura) or lining of the abdomen (...
Metastatic pleural tumor
Metastatic pleural tumor is a type of cancer that has spread from another organ to the thin membrane (pleura) surrounding the lungs.
Risks
There is a slight chance of the needle puncturing the wall of the lung, which can partially collapse the lung. This usually gets better on its own. Sometimes, a chest tube is needed to drain the air and expand the lung.
There is also a chance of excessive blood loss.
Considerations
If a closed pleural biopsy is not enough to make a diagnosis, you may need a surgical biopsy of the pleura.
References
Klein JS, Bhave AD. Thoracic radiology. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 19.
Ly A. Fine-needle aspiration biopsy technique and specimen handling. In: Cibas ES, Ducatman BS, eds. Cytology . 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 8.
Watson N. Respiratory system. In: Watson N. Chapman and Nakielny's Guide to Radiological Procedures . 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 7.
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Pleural biopsy - illustration
In a pleural biopsy, a small piece of pleural tissue in the chest is removed with a needle. The biopsy may distinguish between a cancerous and noncancerous disease. It also can help to detect whether a viral, fungal or parasitic disease is present.
Pleural biopsy
illustration
-
Pleural biopsy - illustration
In a pleural biopsy, a small piece of pleural tissue in the chest is removed with a needle. The biopsy may distinguish between a cancerous and noncancerous disease. It also can help to detect whether a viral, fungal or parasitic disease is present.
Pleural biopsy
illustration
Review Date: 8/11/2015
Reviewed By: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
