Our Summary

This research study looked at the effectiveness and safety of using image-guided lung biopsies in children with weakened immune systems. The children in the study were aged between 0 and 17 years old. Some of the children had received bone marrow or organ transplants, while others had primary immunodeficiency disorders.

A total of 73 biopsies were performed on 68 patients. The aim of the biopsy was to identify the specific organism causing illness so that the right medical treatment could be given.

The results showed that 43 out of 73 patients (roughly 60%) were successfully diagnosed using the biopsy. However, there were also complications. Minor complications occurred in 14 cases (19%) and major complications in 8 cases (11%). Major complications included issues like a collapsed lung or coughing up blood that required further treatment, and in 2 cases, the patient died.

The study also found that the type of imaging used during the biopsy and the use of a fine needle for aspiration affected the rates of complication.

In conclusion, while image-guided lung biopsies can be useful in diagnosing specific illnesses, they come with a higher risk of complications (up to 30%) in patients with weakened immune systems. The researchers suggest that this risk should be carefully discussed with the medical team and the patient’s family before deciding to proceed with the procedure.

FAQs

  1. What was the purpose of this research study on image-guided lung biopsies in children with weakened immune systems?
  2. What were the results and complications of the study on image-guided lung biopsies?
  3. How does the type of imaging and use of a fine needle during biopsy affect the rates of complication?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung biopsy is to make sure to follow all pre-operative instructions provided by the healthcare team. This may include fasting before the procedure, stopping certain medications, and informing the team about any allergies or medical conditions. Following these instructions can help reduce the risk of complications during and after the biopsy. Additionally, it is important to discuss any concerns or questions with your healthcare provider before the procedure to ensure you have a clear understanding of what to expect.

Suitable For

Patients who are typically recommended for a lung biopsy include those with:

  1. Suspicion of lung cancer or other lung tumors
  2. Suspected interstitial lung disease or pulmonary fibrosis
  3. Suspected infections such as tuberculosis, fungal infections, or pneumonia
  4. Suspected autoimmune lung diseases such as sarcoidosis or vasculitis
  5. Suspected lung nodules or masses that need further evaluation
  6. Suspected lung complications following organ or bone marrow transplantation
  7. Suspected primary immunodeficiency disorders affecting the lungs

Overall, patients with complex or difficult-to-diagnose lung conditions may be recommended for a lung biopsy to help determine the underlying cause of their symptoms and guide appropriate treatment.

Timeline

Before the lung biopsy:

  • The patient experiences symptoms that prompt the need for a biopsy, such as persistent cough, chest pain, or difficulty breathing.
  • The patient undergoes imaging tests, such as CT scans, to identify the location of the abnormality in the lung.
  • The patient may undergo blood tests to assess their overall health and ability to undergo the procedure.
  • The patient meets with the medical team to discuss the risks and benefits of the biopsy and give informed consent.

After the lung biopsy:

  • The patient is monitored closely for any immediate complications, such as bleeding or collapsed lung.
  • The patient may experience pain or discomfort at the biopsy site, which can be managed with medication.
  • The patient may need to stay in the hospital for observation, depending on the type of biopsy and any complications that arise.
  • The biopsy sample is sent to a laboratory for analysis to determine the cause of the illness.
  • The patient follows up with the medical team to discuss the biopsy results and develop a treatment plan based on the diagnosis.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung biopsy include:

  1. What is the specific reason for recommending a lung biopsy in my case?
  2. What are the potential risks and complications associated with the biopsy procedure?
  3. How will the biopsy be performed and what type of imaging will be used?
  4. What type of anesthesia will be used during the procedure?
  5. How long will the recovery process take and what can I expect in terms of pain or discomfort?
  6. What are the chances of the biopsy providing a definitive diagnosis?
  7. Are there any alternative diagnostic tests or procedures that could be considered instead of a lung biopsy?
  8. How will the biopsy results be communicated to me and what will be the next steps in my treatment plan?
  9. Are there any specific factors in my case, such as my weakened immune system, that may increase the risk of complications during the biopsy?
  10. What experience does the medical team have in performing lung biopsies, especially in patients with weakened immune systems?

Reference

Authors: Cleveland H, Chau A, Jeng Z, Gardner G, Yoo R, Zhang W, Hernandez J. Journal: J Vasc Interv Radiol. 2020 Jan;31(1):93-98. doi: 10.1016/j.jvir.2019.07.016. Epub 2019 Nov 22. PMID: 31767410