Lung Biopsy

What is Lung Biopsy?
Lung biopsy is a medical procedure in which a sample of tissue from the lung is extracted for examination. The tissue sample is examined in a microbiological laboratory by a pathologist.
A lung biopsy can diagnose cancer, lung infections like tuberculosis, drug reactions and chronic lung diseases like sarcoidosis and pulmonary fibrosis.
Additionally, lung biopsy may also be used for treatments. For example bronchoscopy, a form of lung biopsy can also clear air passages, removing any blockages in the airway.

What are the different types of Lung Biopsy?
The type of lung biopsy that is performed depends on the location of the abnormal tissue, the patient's age and health, and any lung disease that may be present.

The different types of lung biopsies are:
    Bronchoscopic Biopsy
        A bronchoscope, which is a thin, lighted tube, is inserted from the patient's nose or mouth inside the trachea to the bronchi and into the lungs.
        The bronchoscope enables the doctor to view the airways, and it clears mucus and extracts tissue samples for lab tests.
   

Needle Biopsy
        Once the patient is mildly sedated, a CAT scan or a fluoroscopy is used to locate the exact area that requires biopsy.
        Once the area is located, the overylying skin is marked for identification.
        An antiseptic solution is used to clean the skin and a local anesthetic is injected. Then a small incision is made through which a biopsy needle is inserted into the lung tissue.
        After a sufficient amount of tissue is extracted, the needle is withdrawn.
        The incision is covered with a sterile bandage and a chest X-ray is taken immediately after the procedure to detect any complications.
        Needle biopsy takes 30 minutes to one hour.
   

Open Biopsy
        Open biopsy requires general anesthesia and is performed in an operating room. An incision is made over the lung.
        Some tissues of the lung are extracted, after which the incision is closed with sutures.
        Chest tubes are placed in the lungs, which protrude through the closed incision. This is done to drain blood and fluid, and inflate the lungs.
        These chest tubes are removed on the next day after the surgery.
        Immediately after the procedure, a chest X-ray is taken to detect any complications.
        Open biopsy takes approximately one hour.
   

Video Assisted Thoracoscopic Surgery (VATS)
        Video assisted thoracoscopic surgery is a minimally invasive form of lung biopsy and mediastinal lesions biopsy. It is performed on some patients instead of open lung biopsy.
        General anesthesia is administered, and when the patient is unconscious several tiny incisions are made on the patient's chest.
        A thorascope, which is a thin lighted tube with a video camera attached to it, is inserted through an incision.
        Other surgical instruments are inserted through the other incisions to extract the tissue sample for biopsy.
   

Mediastinoscopy
        Mediastinoscopy is performed under general anesthesia.
        An incision measuring about two to three inches is made at the base of the patient's neck.
        A mediastinoscope, which is a thin lighted tube, is inserted through the incision into the area between the left and right lungs.
        Any abnormal lymph nodes and tissues are removed.
        The mediastinoscope is withdrawn after the procedure, and the incision is closed with sutures and covered with a bandage.
        Mediastinoscopy take approximately one hour.

How to Prepare for Lung Biopsy?
    The doctor needs to be informed about any medications that the patient may be taking with or without a prescription.
    Any allergies to medication and anesthesia should also be reported to the doctor.
    The patient may be asked to stop taking certain medications some weeks prior to the biopsy.
    The patient must inform the doctor about any ailments and medical conditions such as heart disease, diabetes or pregnancy.
    If the patient is a smoker, the patient needs to quit smoking and may need to join a smoking cessation program.
    The patient needs to undergo some blood tests before the biopsy.
    The patient needs to sign a consent form before the biopsy.

What type of anesthesia will be given?
General or local anesthesia depending on the type of lung biopsy performed.

How will patient recover?
After a needle biopsy, the patient can resume normal activities in about a week.
- Recovery is sooner in a video-assisted thorascopic surgery (VATS) than an open biopsy.
- Chest tubes that are placed after an open biopsy, VATS or mediastinoscopy can be removed on the next day after the biopsy.
- The patient may experience pain, discomfort and grogginess after a lung biopsy. Pain medication may be required for approximately two weeks after the biopsy.
- The sutures are removed in one to two weeks after the biopsy.

What should be cared?
-The patient should avoid any heavy physical activities after the biopsy.
- The patient should not drive as long as the patient is taking narcotic pain medication.
- The patient can take walks to help in recovery.

The doctor should be informed immediately if the following symptoms are detected:
- Severe chest pain
- Breathing difficulty
- Dizziness
- Bleeding from the incision
- Fever
- Coughing more than a tablespoon of blood