This information is for patients who are having a tiny sample (a biopsy) taken from their lung. It explains what is involved and what significant risks there may be.
A lung biopsy is the removal of a few cells or a tiny sample (a biopsy) of the lung using a needle.
Reasons for having a biopsy
Your tests so far have suggested an abnormality in your lung. Your biopsy samples will be sent for analysis in the Pathology Laboratory which should confirm the nature of the abnormality as well as guide possible treatment.
Your appointment
- You will be sent a letter with details of the date and time of your appointment
- If you are taking blood thinners such as Warfarin, Clopidogrel, Aspirin, Apixaban, Edoxaban, Dabigatran or Rivaroxiban It is important that you inform the Imaging Nurses on (01582) 718174 a as soon as possible before your appointment
- Please also inform us if you are diabetic
- Your Doctor should have arranged some blood tests to check if you are at an increased risk of bleeding. Please ensure these blood tests are taken at least 2 days before the biopsy– if the blood results aren’t available we won’t be able to perform the biopsy
- You must stop eating four hours before your appointment time. You can drink water until 2 hours before your appointment. Please still take any painkillers or blood pressure medications you need at any time with sips of water.
- Another responsible adult must accompany (preferably drive) you home and stay with you overnight after your biopsy procedure
- You should not fly for 6 weeks after your biopsy
On arrival at the hospital
- The appointment letter accompanying this leaflet contains the details of the date and time of your biopsy procedure.
- Your identity will be checked on several occasions whilst you are in the department.
- Reception staff will guide you to a waiting area and a nurse will then greet you and direct you to the scanning area to go through some more details. The Imaging Doctor (Radiologist) will then meet you and discuss the procedure in detail before asking you to sign a consent form to confirm that you understand the procedure and agree to go ahead with it. Please ask the Doctor and Nurse any questions that you may have.
- When these preparations are complete, you will be taken into the scanning room. Most lung biopsies are performed in the CT scanner, a small number are done with the Ultrasound Scanner.
The procedure
- You will be asked to lay on the scanning couch in a position that allows access for the biopsy. You may need to lay on your front. Please let us know if you have concerns about this- most people manage even if they feel unable at first.
- Once in position your skin will be cleaned with antiseptic solution and a local anaesthetic injection will be given under the skin and down to the lining of the lung. This does sting at first but the stinging soon wears off.
- After the local anaesthetic you should feel pushing but should not feel pain. Please let the doctor know if you have any further discomfort or pain.
- We use the scanner to guide a thin hollow needle to the area of possible abnormality in the lung and a second needle is passed through this to take the sample. You will hear a click as this happens.
- The Imaging Nurse will take several sets of observations (Blood pressure, Heart rate, oxygen levels) during the procedure.
- The whole procedure will take about 30 minutes. You can expect to be in the department for at least 2 hours in total.
Risks and complications
This procedure is safe but there are some risks associated with all procedures.
- About one in 10 biopsies does not give sufficient information in the Pathology Lab and needs to be repeated
- In about one in five biopsies, air escapes around the lung, causing it to partially collapse. If this happens, you may experience some pain and breathlessness.
- The lung frequently suffers some internal bruising and around one in ten patients coughs up some blood. This may be unpleasant but it is very unlikely to be concerning. There is also a much smaller risk of internal bleeding around the lung. The blood tests you will have had will confirm that your risk of bleeding is not raised.
- You should also be aware of the very small risk of death as a result of the biopsy, currently believed to be one in 1000 or less. Whilst this sounds alarming, your doctors believe the risk of not doing a biopsy to be far greater.
- If there is lung collapse after the biopsy, two thirds of these patients only need monitoring. One third require a further procedure called a chest drain to resolve the collapse.
Chest Drain
If the doctor advises you that you need a chest drain you will be asked to lie on another couch and undergo a procedure similar to your biopsy. An area is selected below your collar bone and the skin is cleaned with antiseptic solution and more local anaesthetic is injected as before. A small tube is inserted into the area causing collapse and attached to a small plastic valve to allow air around your lung to escape. After a short period of observation if you are feeling well you can go home with the drain tube and valve with instructions on when to come back for it to be removed.
Please speak to the Radiologist before the procedure if you have any concerns about the risks.
After the biopsy
- After the biopsy we will scan for lung collapse immediately. If there is none you will have a chest X-Ray after about 30 minutes. If this is satisfactory and you are feeling well you can go home.
- Another responsible adult must accompany you home and stay with you overnight after your biopsy procedure. You should not drive yourself home.
- You should return to the emergency department immediately if you experience breathlessness or severe pain.
- You should not fly for 6 weeks after your biopsy.
Your biopsy result will be available within 2 weeks, to the Doctor who referred you for the biopsy.