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Pleural needle biopsy

Closed pleural biopsy; Needle biopsy of the pleura

Pleural biopsy is a procedure to remove a sample of the tissue lining, the lungs, and the inside of the chest wall to check for disease or infection.

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Pleural biopsy

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How the Test is Performed

This test may be done in the hospital. It may also be done at a clinic or doctor's office.

The procedure involves the following:

In some cases, pleural biopsy is done using a fiberoptic scope. The scope allows the doctor to view the area of the pleura from which the biopsies are taken.

How to Prepare for the Test

You will have blood tests before the biopsy. You will likely have a chest x-ray.

How the Test will Feel

When the local anesthetic is injected, you may feel a brief prick (like when an intravenous line is placed) and a burning sensation. When the biopsy needle is inserted, you may feel pressure. As the needle is being removed, you may feel tugging.

Why the Test is Performed

Pleural biopsy is usually done to find the cause of a collection of fluid around the lung (pleural effusion) or other abnormality of the pleural membrane. Pleural biopsy can diagnose tuberculosis, cancer, and other diseases.

If this type of pleural biopsy is not enough to make a diagnosis, you may need a surgical biopsy of the pleura.

Normal Results

Pleural tissues appear normal, without signs of inflammation, infection, or cancer.

What Abnormal Results Mean

Abnormal results may reveal cancer (including primary lung cancer, malignant mesothelioma, and metastatic pleural tumor), tuberculosis, other infections, or collagen vascular disease.

Risks

There is a slight chance of the needle puncturing the wall of the lung, which can partially collapse the lung. This usually gets better on its own. Sometimes, a chest tube is needed to drain the air and expand the lung.

There is also a chance of excessive blood loss.

Considerations

If a closed pleural biopsy is not enough to make a diagnosis, you may need a surgical biopsy of the pleura.

Related Information

Collagen vascular disease
Metastatic pleural tumor
Lung cancer - small cell

References

Klein JS, Bhave AD. Thoracic radiology. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 19.

Ly A. Fine-needle aspiration biopsy technique and specimen handling. In: Cibas ES, Ducatman BS, eds. Cytology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 8.

Watson N. Respiratory system. In: Watson N. Chapman and Nakielny's Guide to Radiological Procedures. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 7.

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Review Date: 8/11/2015  

Reviewed By: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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