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(Transthoracic Needle Aspiration; Percutaneous Needle Aspiration)

Definition

This needle biopsy removes a sample of the lung and the lining of the lungs and chest wall (pleura). The sample is tested in a lab.

Female Torso with Respiratory System and Ribcage (Anterior View)
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Reasons for Procedure

This procedure is done to look for abnormal tissue in or around the lung from problems like:

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Infection
  • Bleeding
  • Collapsed lung
  • Damage to the lung, liver, or spleen

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
  • Fasting before the procedure
  • Whether you need a ride to and from the procedure
  • Taking images to find the location of the fluid using:

Anesthesia

The doctor may give:

  • IV medicines to help you relax
  • Local anesthesia—the area will be numbed

Description of the Procedure

You will sit upright on the edge of a bed or chair. Your arms will be resting on a nearby table. An ultrasound or CT scan may be used to locate the biopsy site. A small cut will be made in your skin. Then, while you hold your breath, the biopsy needle will be inserted through the cut. The needle will be passed between your ribs until it reaches the lung or pleura. Some cells will be removed through the biopsy needle. The needle will be taken out. A bandage will be placed on the site.

How Long Will It Take?

30 to 60 minutes

Will It Hurt?

You may pressure when the biopsy needle is inserted. You may also feel a tugging when it is taken out.

Post-procedure Care

At the Care Center

The sample will be sent to a lab for testing. Another image may be taken to make sure your lungs are working well.

At Home

Physical activity may be limited for up to a week.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or any discharge from the site
  • Pain that is not eased by medicine
  • Pain when taking a deep breath
  • Cough, shortness of breath, or chest pain
  • Fast heartbeat
  • Coughing up blood

If you think you have an emergency, call for medical help right away.

RESOURCES

American Cancer Society  http://www.cancer.org 

American Lung Association  http://www.lung.org 

CANADIAN RESOURCES

Canadian Cancer Society  http://www.cancer.ca 

The Lung Association  http://www.lung.ca 

References

Needle biopsy of the lung. Radiological Society of North America Radiology Info website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=nlungbiop. Updated April 21, 2020. Accessed May 5, 2020.

Needle biopsy of the lung, pleura, mediastinum, or adrenal glands. Memorial Sloan Kettering Cancer Center website. Available at: http://www.mskcc.org/cancer-care/patient-education/resources/needle-biopsy-lung-pleura-mediastinum-adrenal-glands. Updated October 24, 2019. Accessed May 5, 2020.

Pleural biopsy. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test%5Fprocedures/pulmonary/pleural%5Fbiopsy%5F92,p07757. Accessed May 5, 2020.

Thoracentesis. EBSCO DynaMed website. Available at:  https://www.dynamed.com/procedure/thoracentesis . Updated March 25, 2020. Accessed May 5, 2020.

Transthoracic needle biopsy. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/pulmonary%5Fdisorders/diagnostic%5Fpulmonary%5Fprocedures/transthoracic%5Fneedle%5Fbiopsy.html. Updated June 2019. Accessed May 5, 2020.

Types of biopsy procedures. American Cancer Society website. Available at: https://www.cancer.org/treatment/understanding-your-diagnosis/tests/testing-biopsy-and-cytology-specimens-for-cancer/biopsy-types.html. Updated July 30, 2015. Accessed May 5, 2020.

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