Pleural needle biopsyDefinition: 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: Closed pleural biopsy; Needle biopsy of the pleura
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 As the needle is being withdrawn, you may feel a tugging sensation.
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.
Normal Values: 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:
What the risks are: 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.
Special considerations: If a closed pleural biopsy is unsuccessful at making a diagnosis, surgical biopsy of the pleura may be required in some cases.
References: Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000:1926-1927. Noble J. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001:725.
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