Biopsy of lung is a process for acquiring a small sample of lung tissue for analysis. The tissue is generally tested under a microscope, and may be referred to a microbiological laboratory for culture test. Microscopic test is conducted by a pathologist.
A lung biopsy is generally undertaken to ascertain the cause of abnormalities, such as nodules that is detected on chest X rays. It can confirm detection of cancer, specifically if malignant cells are eliminated in the patient's saliva or bronchial washing. Apart from evaluating lung tumors and their allied symptoms, biopsy of lung may be facilitated to diagnose lung infections, specifically tuberculosis and Pneumocystis pneumonia, drug reactions, and chronic illness of the lungs , for instance sarcoidosis and pulmonary fibrosis.
A lung biopsy can be facilitated for treatment as well as diagnosis. Bronchoscopy, a kind of lung biopsy conducted using a long, flexible slender tool termed as bronchoscope, can be facilitated to clear a patient's air passages of secretions and to discard airway blockages.
As per the data of the American Cancer Society, nearly 77% of all cancers are detected in people of age group of 55 and older. Lung cancer is the prominent cause of cancer deaths in the US. Every year, nearly 170,000 Americans are detected with lung cancer. It is much more prevalent among African Americans compared to the general population. Nine out of 10 cases of lung cancer are resultant of smoking cigarettes, pipes, or cigars.
Biopsy of lung is performed facilitating several techniques, depending on where the abnormal tissue is lodged in the lung, the health and age of the patient, and the diagnosis of lung disease. A bronchoscopy is suggested if a lesion identified on the x-ray appears to be located on the wall (periphery) of the chest. If the suspicious location is closer to the chest wall, a needle biopsy is prescribed. If both processes fail to diagnose the trouble, an open lung biopsy can be performed. When there is a query about whether the lung cancer or suspicious bulk has reached the lymph nodes in the mediastinum, a mediastinoscopy is suggested.
In the process of bronchoscopy, a thin, lightweight tube (bronchoscope) is cross passed from the nose or mouth, down the windpipe (trachea) to the airways (bronchi) heading towards the lungs. Using the bronchoscope, the doctor views the airways, and clears the mucus from blocked airways, and takes cells or tissue samples for laboratory examination.
The patient is slightly sedated, but left in conscious condition during the needle biopsy procedure. The patient sits in a chair with arms folded in the front resting on a table. An x-ray technician facilitates a computerized axial tomography (CAT) scanner or a fluoroscope to detect the precise site of the suspicious areas. Markers are put on the overlying skin to identify the biopsy location. The skin is properly cleansed using an antiseptic fluid, and a local anesthetic is administered to numb the area. The patient will feel a short stinging sensation when the anesthetic is administered.
The physician created a small incision, about half an inch or 1.25 cm long. The patient is instructed to take a deep breath and hold it while the doctor inserts the biopsy needle through the incision into the lung to conduct the biopsy. The patient may feel some pressure and a short sharp pain when the needle reaches the lung tissue. Most patients do not feel severe pain also. The patient should restrain from coughing while the process of biopsy of lung is going on. The needle is withdrawn when sufficient tissue has been taken. Pressure is applied at the biopsy location and a sterile bandage is pressed over the incision. A chest x-ray is followed immediately after the procedure to check for potential complications. The whole procedure takes 30 to 60 minutes of time.
Open biopsies are conducted in an operating room of some hospital using general anesthesia. Once the anesthesia has started working, the surgeon creates an incision over the lung area, through a process termed as thoracotomy. Some lung tissues are taken out and the incision is packed with sutures. Chest tubes are inserted with one end inside the lung and the other end projecting out of the through the closed incision. Chest tubes are facilitated to flush fluid and blood, and re-pump the lungs. They are generally removed the day after the biopsy. The whole procedure usually lasts for about an hour. A chest x ray is conducted immediately after the biopsy check for suspected complications.
This is the least invasive technique, which can be facilitated for biopsy of lung and mediastinal lesions. VATS may be conducted on very few patients in place of open lung biopsy. In this the patient is placed under general anesthesia and the surgeon makes multiple tiny incisions in the patient’s chest wall. A thorascope, a thin, hollow, light tube accompanied by a small video camera is inserted via one of the small incisions. The other incisions are used by the surgeon to insert specific instruments to retrieve tissue for the biopsy.
This procedure is undertaken under the influence of general anesthesia. A 2–3 inch or 5–8 cm incision is created at the base of the neck. A hollow, thin, and light weight tube, called a mediastinoscope, is put through the incision into the space between the right and the left lungs. The surgeon takes off any lymph nodes or tissues that look unusual. The mediastinoscope is then taken out and the incision is sutured and covered with bandage. A mediastinoscopy lasts for an hour.
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