ADAM Health Encyclopedia

Pleural needle biopsy

Definition

A pleural biopsy is surgery to remove a sample of the tissue that lines the lungs and the inside of the chest wall. A specialist uses a microscope to look at the tissue and check for disease or infection.

Alternative Names

Why the Test is Performed

Pleural biopsy is usually done to determine the cause of a persistent pleural effusion (collection of fluid around the lung) or other abnormality of the pleural membrane. Diseases that may be diagnosed by pleural biopsy include tuberculosis and cancer.

How the Test is Performed

This test does not have to be done in the hospital. It may be done at a clinic or doctor's office. You will be sitting up for the biopsy. The skin at the biopsy site will be cleansed, and a local numbing drug (anesthetic) will be injected into the skin and into the lining of the lungs and chest wall (pleural membrane).

A larger, hollow needle is then placed through the skin and into the chest cavity. The doctor rotates the needle.  At various times during the procedure, you will be asked to sing, hum, or say "eee." This helps prevent air from getting into the chest cavity, which can cause a pneumothorax (lung collapse).

When the doctor removes the needle, tissue samples are collected. Usually, three biopsy samples are taken. When completed, a bandage is placed over the biopsy site.

How to Prepare for the Test

Blood tests will be done before the biopsy, and a chest x-ray may also be taken. You must sign consent forms.

How the Test Will Feel

With the injection of the local anesthetic, there may be a brief prick and a burning sensation. When the biopsy needle is inserted, you may feel pressure. As the needle is being withdrawn, you may feel a tugging sensation.

Risks

There is a slight chance of the needle puncturing the wall of the lung, which can produce a partial collapse of the lung. This usually resolves on its own. There is a chance of excessive blood loss.

Considerations

If a closed pleural biopsy is unsuccessful at making a diagnosis, surgical biopsy of the pleura may be required in some cases.

Normal Results

The pleural tissues appear normal, without evidence of inflammation, infection, or malignancy.

What Abnormal Results Mean

The abnormal results may reveal cancer, tuberculosis, a viral disease, a fungal disease, a parasitic disease, or collagen vascular disease.

Additional conditions under which the test may be performed include:

• Metastatic pleural tumor
• Primary lung cancer