Pulmonary
- Critical Care Associates
of East Texas
Jeffrey M.
Shea, M.D., F.C.C.P.
Catherine M. Martinez, M.D.
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Jeffrey M.
Shea, M.D., F.C.C.P. |
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Purpose Pleural biopsy is a procedure whereby samples of the pleural tissue (the lining around the chest wall) are removed and examined under a microscope as well as sent for cultures. Pleural biopsies are generally performed when a patient has a pleural effusion that, after a thoracentesis, has the characteristics of cancer or tuberculosis but there are no identifiable cancer cells or TB bacteria on stain or culture. This tissue is used to look for granulomas of tuberculosis or implants of tumor cells from a malignant process. The biopsy helps distinguish between cancerous and non-cancerous disease. It also helps detect whether a viral, fungal or parasitic disease is present. Technique Blood tests and chest x-rays may be done prior to the procedure. The procedure is generally done on an outpatient basis, and only requires local anesthesia. The pleura is a membrane that lines the inside of the chest cavity. The patient can either be sitting up or lying down. The biopsy site is cleansed and then a local anesthetic is given. The patient may feel a brief prick of a needle and some burning sensation, but this will numb the skin. A needle is then inserted sterilely through the skin so that a biopsy can be taken. The needle is rotated and tissue samples are withdrawn. Once this is done the biopsy site requires only a small bandage and the patient is monitored for a short time. Risks of Pleural Biopsy As in all invasive procedures, there is always the risk of infection. This procedure is performed sterilely, with a sterile drape, sterile gloves, and all equipment is sterile. The risk of bleeding also exists, although infrequent. Biopsies are only taken at the 3 through 9 o'clock positions to avoid injury to the vein and artery that course under the ribs. There is also the risk of a pneumothorax (air around the lung). For this reason, a chest x-ray is always done after the biopsy. |
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