Radiology - Lung Biopsy

What is a lung biopsy?

A lung biopsy is a way of getting a sample of lung tissue using a small needle.

What are the benefits?

Obtaining a tissue sample from your lung for examination allows us to investigate your condition further, aiding diagnosis.

Are there any alternatives?

Your doctor has advised that you need this test. Other options include surgery, although this is not appropriate for everyone. Another option is to do nothing, which can either mean to literally do nothing or to observe your lesion by chest x-ray or CT scan. Your suitability for these options should have been discussed with you before the decision for a lung biopsy was made. There are risks associated with delaying treatment whilst observing. An example of this would include cancer, as it could spread if left untreated. The earlier the treatment starts the better.

Will I need a general anaesthetic?

No. A lung biopsy is done under local anaesthetic. A small injection is used to numb the skin.

What happens now?

You will receive a letter or phone call telling you when and where to report. The biopsy will normally be done within 2 weeks.

Can I eat and drink before the test?

Please do not eat anything for 4 hours prior to your appointment. You may drink some water or clear fluid up to 2 hours before your procedure.

Do I take my tablets on the day of the test?

If you are on any blood thinning tablets or injections (Warfarin, Synthrone, Clopidogrel, Ticagrelor, Prasugrel, Rivaroxaban, Apixaban, Dabigatran, Edoxaban or Dalteparin) then these will need to have been stopped prior to the procedure and you may need to be issued with alternative medicine. The doctor in clinic should have checked your medicines with you. If you are taking any of these medicines and you have not been advised when to stop them or are unsure, please can you contact the lung nurses or respiratory secretaries to be advised when to stop these prior to the procedure. You should take all other tablets as normal.

What happens next?

A blood sample is usually taken before the procedure. This may be done in clinic or on the day when you attend the hospital for the test. The doctor who performs the biopsy is an x-ray specialist, called a radiologist. A CT or ultrasound machine is used to let the doctor know exactly where to take the samples from. The doctor then gives a local anaesthetic and passes a small needle into the relevant area in the lung and takes tiny samples of tissue. The samples are then sent to the laboratory and examined under the microscope by a specialist called a pathologist.

Will it hurt me?

Whilst it shouldn’t be painful, sometimes people do experience some discomfort during the test. This doesn’t usually last very long. If you feel any discomfort during the test, please inform the radiologist during the procedure. Some people have a bit of pain afterwards once the anaesthetic has worn off. If you do have pain you can take a painkiller like paracetamol (up to 2 tablets, 4 times a day).

How long does the test take?

This can usually take up to 45 minutes.

Can I go home after the procedure?

Most people can go home after a few hours, but there must be someone to stay with you overnight.

What are the risks of having a lung biopsy?

It is quite common for a little air to escape into the space around the lung during the biopsy. This may cause the lung to partially collapse. We call this a pneumothorax. Recent research shows that this may happen in around 1 in 5 procedures. Usually, a pneumothorax is small and does not cause any problems. Rarely, (in 3% of procedures), a lot of air leaks out and causes a big pneumothorax. If this were to happen, then we would treat it by sucking the air out again with a needle (aspiration) or by putting in a tube (called a chest drain) to let the air out again. You would probably have to stay in hospital for a day or two after this procedure. It is quite normal to cough up some streaks of blood for a day or two after the procedure. Bleeding is relatively uncommon but usually happens immediately and stops after 5 to 10 minutes without needing any treatment.

There is no such thing as a completely safe invasive medical test or procedure and lung biopsy is known to be associated with an extremely rare but serious complication which can potentially result in death. However, the chance of such a serious complication arising from this test is no higher than having a general anaesthetic or camera test.

Will there be any side effects after the biopsy?

Most people have no problems. If you suddenly become short of breath or have severe chest pain, then this may mean that there has been an air leak (a pneumothorax). You should contact the hospital straight away to be seen for a chest x-ray. If necessary, you may be asked to attend the accident and emergency unit at the hospital.

Can I drive after the biopsy?

No. Someone else must drive you home after the test. If you feel well, you should be able to drive the next day.

Are there any problems with flying in an aircraft after a biopsy?

You should not fly for six weeks after your procedure. If you wish to fly in less than six weeks, please discuss this with your hospital doctor.

When can I go back to work?

You should be able to go back to work the day after the lung biopsy unless advised otherwise.

When will I get the results?

It can take up to a week before your doctor receives the results. You should have been given an appointment to see your doctor again. If you have not heard from the hospital within 10 days after the biopsy, you should telephone the consultant’s secretary to make another appointment.

If you need any further information, please contact:

The lung specialist nurse:

Fairfield Hospital, Bury: Carol Telford/Lesley Valentine Telephone: 0161 778 2693

Royal Oldham Hospital: Chrissie Charlesworth Telephone: 0161 778 5481

Royal Oldham Hospital/Rochdale Infirmary: Amanda Dand Telephone: 0161 627 8527

Salford Royal Hospital: Josh Wharton Telephone: 0161 206 5771

Please ask about anything you do not fully understand or wish to have explained in more detail.

Could you be pregnant?

If there is any chance you could be pregnant, please call 0161 206 5091 if your appointment is at Salford Royal Hospital. Please call 0161 656 1178 if your appointment is at Royal Oldham Hospital.

Is x-ray guidance dangerous?

All x-ray machines use potentially harmful x-rays. Modern equipment is designed to keep the dose you receive as low as possible. If your doctor has asked for this test, they will have decided that the benefits from the procedure outweigh the risks from the very small dose of radiation that you receive.

What if I cannot attend my appointment?

If you have any queries about your appointment or cannot attend, then please telephone the booking office on 0161 204 2044/2404 (Salford Royal Hospital) or 0161 624 0420 (Royal Oldham Hospital) Monday to Friday 8.30am to 4.00pm.

You can also email booking.radiology@nca.nhs.uk (Salford Royal Hospital) or bookingandscheduling.outpatients@nca.nhs.uk (Royal Oldham Hospital). Please include name, date of birth, address and hospital number (if known) in any correspondence.

I need an ambulance. How do I arrange one?

If you need an ambulance there are contact details on your appointment letter.

Please contact us if you are arriving by ambulance so we can time your appointment with your ambulance arrival. If we are not aware that you are coming by ambulance you may miss your appointment and it may have to be rebooked.

If you need an interpreter

If you need an interpreter for your examination, please call the department so that we can try and arrange this.

Contact Details

We hope your questions have been answered by this leaflet.

If you require help or any other information regarding your appointment you can contact: -

The Angiography Department, Salford Royal Hospital
Tel: 0161 206 2206/5091

Interventional Radiology, Royal Oldham Hospital
Tel: 0161 656 1178