Lung biopsy

Percutaneous lung biopsy in a case of suspected lung cancer under control of computed tomography.

A lung biopsy is an interventional procedure performed to diagnose lung pathology by obtaining a small piece of lung which is examined under a microscope.[1][2] Beyond microscopic examination for cellular morphology and architecture, special stains and cultures can be performed on the tissue obtained.[3]

A lung biopsy can be performed percutaneously (through the skin, typically guided by a CT Scan), via bronchoscopy with ultrasound guidance, or by surgery, either open or by video-assisted thoracoscopic surgery (VATS).

Reasons to perform

A lung biopsy is performed when a lung lesion is suspicious for lung cancer, or when cancer cannot be distinguished from another disease, such as aspergillosis.

Lung biopsy also plays a role in the diagnosis of interstitial lung disease.[4]

Risks

Pneumothorax

Any approach to lung biopsy risks causing a pneumothorax. Careful technique can limit this risk, which ranges from less than 1% to about 10%. The precise risk of pneumothorax depends on technique and on underlying lung disease, as certain lung diseases such as COPD can increase the risk of pneumothorax. Pneumothorax sometimes requires tube thoracostomy.

Bleeding

Bleeding can be life-threateneing and can occur in 1 to 4%.[5]

References

  1. ↑ Thomas W. Shields; Joseph LoCicero; Carolyn E. Reed (21 December 2011). General Thoracic Surgery. Lippincott Williams & Wilkins. p. 317. ISBN 978-1-4511-5278-4.
  2. ↑ Mostafa M. Fraig (21 April 2015). Diagnosis of Small Lung Biopsy: An Integrated Approach. Springer. ISBN 978-1-4939-2575-9.
  3. ↑ DiBardino, DM; Yarmus, LB; Semaan, RW (2015). "Transthoracic needle biopsy of the lung". J Thorac Dis. 7: S304–16. PMC 4700361 Freely accessible. PMID 26807279. doi:10.3978/j.issn.2072-1439.2015.12.16.
  4. ↑ Sindhwani, G; Shirazi, N; Sodhi, R; Raghuvanshi, S; Rawat, J (2015). "Transbronchial lung biopsy in patients with diffuse parenchymal lung disease without 'idiopathic pulmonary fibrosis pattern' on HRCT scan - Experience from a tertiary care center of North India". Lung India. 32 (5): 453–6. PMC 4586998 Freely accessible. PMID 26628758. doi:10.4103/0970-2113.164148.
  5. ↑ Bradley, B; Branley, H. M.; Egan, J. J.; Greaves, M. S.; Hansell, D. M.; Harrison, N. K.; Hirani, N; Hubbard, R; Lake, F; Millar, A. B.; Wallace, W. A.; Wells, A. U.; Whyte, M. K.; Wilsher, M. L.; British Thoracic Society Interstitial Lung Disease Guideline Group, British Thoracic Society Standards of Care Committee. (2008). "Interstitial lung disease guideline: The British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society". Thorax. 63 Suppl 5: v1–58. PMID 18757459. doi:10.1136/thx.2008.101691.
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