What is pleural biopsy?
Pleural biopsy is a diagnostic technique in which the pleura, the tissue that lines the inside of the chest, is removed and analyzed.
What does pleural biopsy consist of?
There are three types of biopsy depending on the technique used:
- Needle biopsy: also called thoracentesis, it is the most commonly used technique, and consists of introducing a special needle into the pleural cavity (space between the chest wall and the pleura) to obtain the sample. It is performed under local anesthesia and may use ultrasound or computed tomography tools to correctly guide the insertion of the needle.
- Thoracoscopic biopsy: consists of inserting a special endoscope into the pleural cavity under local or general anesthesia. Through the endoscope, the pleural tissue can be visualized and any suspicious tissue can be analyzed.
- Open biopsy: under general anesthesia, it consists of making an incision in the skin and removing a portion of the pleura by surgery.
Why is pleural biopsy performed?
The main reasons for performing this type of biopsy are:
- To diagnose the cause of a pleural infection.
- To evaluate an abnormality of the pleura seen on a chest x-ray.
- Determine whether a pleural mass is malignant or benign
- Investigate a pleural effusion (fluid accumulated in the pleural cavity)
- Obtain more information if a pleural fluid analysis suggests the presence of cancer, tuberculosis, or infection
Preparation for pleural biopsy
Fasting before the procedure is not usually required. What is important for preparation is to inform the specialist of the following:
- Medications and herbal supplements you take
- History of bleeding disorders
- You are taking anticoagulant drugs or other drugs that affect blood clotting
- Are pregnant or suspect that you are pregnant
You may also have a diagnostic procedure performed first, such as a CT scan, chest x-ray, ultrasound, or chest fluoroscopy to identify the exact site where the procedure should be performed.
What does the test feel like?
In a pleural needle biopsy, although the area is anesthetized, some pressure may be felt when the needle is inserted. Once the pleural fluid is removed, the needle is withdrawn and firm pressure is applied to the area until the bleeding stops.
What abnormal pleural biopsy results mean
Abnormal results on this procedure may mean:
- Lung cancer
- Neoplasm (abnormal tissue growth)
- Tuberculosis
- Disease caused by a virus, fungus, or parasite
- Collagen vascular disease
- Mesothelioma (tumor in the lungs, heart or stomach)