A lung biopsy is a procedure where doctors remove a small amount of tissue from your lung. They usually order a biopsy if a chest X-ray or CT scan shows an unusual spot or shadow.

Experts examine the tissue under a microscope to diagnose or stage various lung conditions. We do most lung biopsies to check for cancer. But we may also use it to find:

• Interstitial lung disease (ILD)
• Sarcoidosis
• Tuberculosis
• Viral, fungal, or parasitic disease
• Fluid in the lungs

Types of lung biopsies

The kind of biopsy you have may depend on where the problem area is in your lung. Some lung nodules are more challenging to access. Your doctor will talk to you about what type of biopsy is best for you.

• Radiologic needle biopsy: The doctor inserts a hollow needle into the lung to collect tissue samples. We use pictures from a CT scan, X-ray, or ultrasound to guide the needle.
• Endoscopic biopsy: Doctors insert a thin tube through the mouth or nose, then into the airways and lung where the mass is. A small camera with a light (bronchoscope) allows doctors to see into your lungs.
• Computer-guided needle biopsy: Instead of using pictures, this test uses real-time imaging to find nodules and sample them with a needle.
• Open lung biopsy: Involves a larger incision in the chest wall. Doctors may use it when other techniques won’t allow them to get to the problem area.
• Video-assisted thoracoscopic surgery (VATS) biopsy: Doctors make a small incision in the chest and use a small video camera to view the lungs. It’s less invasive than an open lung biopsy but more invasive than an endoscopic biopsy.

You may need a lung biopsy if a lung cancer screening test shows a spot or nodule, if you have another type of cancer that may have spread to your lungs or if you have a lung condition but no diagnosis yet.

A lung biopsy can:

• Confirm the presence of cancer in a pulmonary nodule
• Rule out cancer if a lung nodule is benign
• Help doctors find out the stage of your lung cancer
• Diagnose infections and inflammation
• Find diseases like tuberculosis, sarcoidosis, and pulmonary fibrosis
• Give doctors answers when other tests are inconclusive

Your doctor will talk to you about what to expect with your lung biopsy. Specifics may be different depending on the type of biopsy you have. But in general, here are some things you can expect. 

Before your lung biopsy

We’ll ask you not to eat or drink anything for 6 – 8 hours before your biopsy. Your doctor will talk to you about whether it’s ok to take any regular medicines. You can’t take nonsteroidal anti-inflammatory drugs (NSAIDs like ibuprofen) or blood thinners for a certain time before the biopsy.

You’ll get sedation, so you should plan for someone to drive you home afterwards. It’s also helpful to have a loved one with you to listen to the home care instructions. With preparation and recovery time, plan to be at the hospital for a few hours.

At the hospital, you’ll change into a gown. We’ll give you medicine that helps you relax, and you’ll lie down on a table.

During your lung biopsy

For a needle biopsy, the radiologist will clean the skin where the needle will go. They’ll put a sterile drape around the area and numb it. The imaging machines will guide the needle as doctors insert it through the skin.

The needle will go into the nodule or abnormal tissue. A small piece of tissue will come out with the needle. You may feel pressure or a moment of pain when the needle enters the lung.

For an endoscopic biopsy, the doctor will spray your mouth and throat with a numbing solution. That will help control any coughing when the bronchoscope goes into your mouth. Tiny instruments like tweezers or hollow needles will collect the tissue samples from the lung.

The whole biopsy procedure should only take about 30 – 60 minutes.

After your lung biopsy

Nurses will observe you for a time after the procedure to make sure there are no complications. We perform many lung biopsies every year. It’s a safe procedure. But every lung procedure carries some risks. 

A pathologist will look at your tissue sample under a microscope. You should get results in a few days.