lung biopsy

ASSIGNEMENT

                                   ON

Lung biopsy

    

Lung Biopsy

A lung biopsy removes a small piece of lung tissue which can be looked at under a microscope. The biopsy can be done in four ways. The method used depends on where the sample will be taken from and your overall health.

A lung needle biopsy is used to gather a piece of lung tissue for testing and examination. It is often used to diagnose an irregular area of tissue in or around the lungs. The technique is also called percutaneous needle aspiration.

INDICATIONS

§  Monitor the progression of lung disease

§  Stage a malignant (cancerous) lung tumor

§  Identify the cause of inflammation in the lung

§  Explain why fluid has collected in the lung

§  Determine whether a lung mass is malignant or benign

§  Diagnose a lung infection.

Bronchoscopic biopsy.

§  This type of biopsy uses a lighted instrument (bronchoscope) inserted through the mouth or nose and into the airway to remove a lung tissue sample. This method may be used if an infectious disease is suspected, if the abnormal lung tissue is located next to the breathing tubes (bronchi), or before trying more invasive methods, such as an open lung biopsy.

Needle biopsy

                             

§  A needle biopsy uses a long needle inserted through the chest wall to remove a sample of lung tissue. This method is used if the abnormal lung tissue is located close to the chest wall. A computed tomography (CT) scan, an ultrasound, or fluoroscopy are usually used to guide the needle to the abnormal tissue.

Open biopsy

§  An open biopsy uses surgery to make a cut (incision) between the ribs and remove a sample of lung tissue. An open biopsy is usually done when the other methods of lung biopsy have not been successful, cannot be used, or when a larger piece of lung tissue is needed for a diagnosis.

§  Video-assisted thoracoscopic surgery (VATS). VATS uses a scope (called a thoracoscope) passed through a small incision in the chest to remove a sample of lung tissue.

How the Test is Performed

§  The procedure usually takes 30 to 60 minutes. The biopsy is done in the following way: A chest x ray or chest CT scan may be used to find the exact spot for the biopsy.

§   If the biopsy is done using a CT scan, you may be lying down during the exam. You may be given a mild sedative to relax you.

§  A needle biopsy of the lung may also be done during bronchoscopy or mediastinoscopy. You sit with your arms resting forward on a table. Your skin where the biopsy needle is inserted is scrubbed. A local painkilling medicine (anesthetic) is injected.

§  The doctor makes a small cut in your skin.

§  The biopsy needle is inserted into the abnormal tissue, tumor, or lung tissue. A small piece of tissue is removed with the needle. The needle is removed. Pressure is placed on the site. Once bleeding has stopped, a bandage is applied.

§  A chest x ray is taken right after the biopsy.

§  The biopsy sample is sent to the lab. Analysis usually takes a few days.

How to Prepare for the Test

§  You should not eat for 6 to 12 hours before the test. Follow instructions about not taking aspirin, non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or blood thinners such as warfarin for a period of time before the procedure. Check with your health care provider before changing or stopping any medications. Before a needle biopsy of the lung, a chest x ray or chest CT scan may be performed.

Normal Results

§  In a normal test, the tissues are normal and there is no cancer or growth of bacteria, viruses, or fungi if a culture is performed.

What Abnormal Results Mean

§  Bacterial, viral, or fungal lung infection Cancerous cells (lung cancer, mesothelioma) Pneumonia.

Risks

§  Sometimes, a collapsed lung (pneumothorax) occurs after this test. A chest x ray will be done to check for this. The risk is higher if you have certain lung diseases such as emphysema. Usually, a collapsed lung after a biopsy does not need treatment. But if the pneumothorax is large or does not improve, a chest tube is inserted to expand your lung. In rare cases, pneumothorax can be life threatening if air escapes from the lung, gets trapped in the chest, and presses on the rest of your lungs or heart. Whenever a biopsy is done, there is a risk of too much bleeding (hemorrhage). Some bleeding is common, and a health care provider will monitor the amount of bleeding. In rare cases, major and life threatening bleeding can occur.

CONTRAINDICATION

§  A needle biopsy should not be performed if other tests show that you have: Blood coagulation disorder of any type Bullae (enlarged alveoli that occur with emphysema) Cor pulmonale, Cysts of the lung, Pulmonary hypertension, Severe hypoxia (low oxygen).

References

§  Ettinger DS. Lung cancer and other pulmonary neoplasms. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011: chap 197.

§  Silvestri GA, Jett JR. Clinical aspects of lung cancer. In: Mason RJ, Broaddus CV, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 47.

BOOK:-

1.      Brunner and sidharth, A tesxt book for Medical Surgical

2.      Chintamani, Atext book for Medical Surgical

3.      I Clement, A text book for practical procedure.