What is a lung biopsy?
A biopsy is a procedure performed to remove tissue or cells from the body for examination under a microscope. A lung biopsy is a procedure in which samples of lung tissue are removed (with a special biopsy needle or during surgery) to determine if lung disease or cancer is present.
A lung biopsy may be performed using either a closed or an open method. Closed methods are performed through the skin or through the trachea (windpipe). An open biopsy is performed in the operating room under general anesthesia.
The various biopsy procedures include:
Needle biopsy. After a local anesthetic is given, the doctor uses a needle that is guided through the chest wall into a suspicious area with computed tomography (CT or CAT scan) or fluoroscopy (a type of X-ray “movie”) to obtain a tissue sample. This type of biopsy may also be referred to as a closed, transthoracic, or percutaneous (through the skin) biopsy.
Transbronchial biopsy. This type of biopsy is performed through a fiberoptic bronchoscope (a long, thin tube that has a close-focusing telescope on the end for viewing) through the main airways of the lungs (bronchoscopy).
Thoracoscopic biopsy. After a general anesthetic is given, an endoscope is inserted through the chest wall into the chest cavity. Various types of biopsy tools can be inserted through the endoscope to obtain lung tissue for examination. This procedure may be referred to as video-assisted thoracic surgery (VATS) biopsy. In addition to obtaining tissue for biopsy, therapeutic procedures, such as the removal of a nodule or other tissue lesion may be performed.
Open biopsy. After a general anesthetic is given, the doctor makes an incision in the skin on the chest and surgically removes a piece of lung tissue. Depending on the results of the biopsy, more extensive surgery, such as the removal of a lung lobe may be performed during the procedure. An open biopsy is a surgical procedure and requires a hospital stay.
Intra-operative consultation (frozen section)
Sometimes a surgeon needs information about a tissue sample during surgery to make immediate
surgical decisions. If the surgeon cannot wait the day or more that it will take for routine
processing and histology, he or she will request an intra-operative (during surgery) pathology
consultation. This is often called a frozen section exam.