Our Summary

This research paper looks at how to effectively biopsy lung tumors that are close to the esophagus. In particular, it explores what is meant by “immediately adjacent” and tries to find out the maximum distance between the tumor and the esophagus that makes a biopsy possible.

The researchers studied patients with lung tumors that were at most 6 cm from the esophagus and who were candidates for a specific type of biopsy known as EUS-B-FNA. They also took into account the size of the tumors.

From the data, they found out that it was possible to biopsy all tumors that were less than 19 mm from the esophagus. However, the maximum distance that allowed for a successful biopsy depended on the size of the tumor.

Based on these results, the researchers created a formula that can predict whether a biopsy will be successful, depending on the distance from the esophagus and the size of the tumor. They found that the maximum distance that allowed for a successful biopsy, after adjusting for tumor size, was 31 mm.

To simplify, this study helps doctors determine how far a lung tumor can be from the esophagus for a specific kind of biopsy to still work, and this distance depends on how big the tumor is.

FAQs

  1. What does “immediately adjacent” mean in the context of lung tumors and the esophagus?
  2. What is the maximum distance between a lung tumor and the esophagus that allows for a successful biopsy?
  3. How does the size of the lung tumor affect the success of a biopsy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lung biopsy is to make sure to follow all pre-biopsy instructions given by the healthcare team, such as fasting before the procedure if required. It is also important to inform the healthcare team about any medications or allergies beforehand. After the biopsy, it is crucial to follow post-procedure care instructions and watch for any signs of infection or complications, such as increased pain, fever, or difficulty breathing, and to seek medical attention if any of these symptoms occur.

Suitable For

Patients who are typically recommended for lung biopsy include those with suspicious lung nodules or masses that need further evaluation to determine if they are cancerous or benign. Additionally, patients with lung cancer or other lung diseases may also undergo a lung biopsy to help guide treatment decisions and determine the best course of action. In the case of this research paper, patients with lung tumors that are close to the esophagus and are candidates for EUS-B-FNA biopsy would be recommended for a lung biopsy.

Timeline

Before the lung biopsy:

  1. The patient undergoes a consultation with their doctor to discuss the need for a lung biopsy and the risks and benefits associated with the procedure.
  2. The patient may undergo imaging tests such as a CT scan or MRI to locate the tumor and determine the best approach for the biopsy.
  3. The patient may need to undergo blood tests and other pre-operative evaluations to ensure they are fit for the procedure.
  4. The patient may be advised to stop taking certain medications, such as blood thinners, before the biopsy.
  5. The patient may be instructed to fast for a certain period of time before the procedure.

During the lung biopsy:

  1. The patient will be given a local anesthetic to numb the area where the biopsy will be performed.
  2. The doctor will use a needle or a small surgical instrument to obtain a sample of tissue from the lung tumor.
  3. The patient may feel some pressure or discomfort during the procedure, but it is typically well-tolerated.
  4. The biopsy sample will be sent to a lab for analysis to determine if the tumor is cancerous or benign.

After the lung biopsy:

  1. The patient may experience some pain or discomfort at the biopsy site, which can be managed with over-the-counter pain medications.
  2. The patient may be advised to rest and avoid strenuous activities for a few days after the procedure.
  3. The doctor will discuss the results of the biopsy with the patient and recommend further treatment options if needed.
  4. The patient may need to undergo follow-up imaging tests to monitor the tumor and assess its response to treatment, if necessary.

What to Ask Your Doctor

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

  1. What type of biopsy procedure will be performed on my lung tumor?
  2. How close is the tumor to my esophagus, and will this affect the biopsy procedure?
  3. What is the success rate of the biopsy procedure for tumors close to the esophagus?
  4. What are the potential risks and complications associated with the biopsy procedure?
  5. Will I need any special preparation before the biopsy procedure?
  6. How long will it take to get the biopsy results?
  7. What follow-up care will be required after the biopsy?
  8. Are there any alternative options for biopsy if the tumor is close to the esophagus?
  9. How experienced is the medical team in performing this type of biopsy procedure?
  10. Can you explain the formula or criteria used to determine if a biopsy will be successful based on the distance from the esophagus and the size of the tumor?

Reference

Authors: Christiansen IS, Svendsen MBS, Bodtger U, Sidhu JS, Nessar R, Salih GN, Høegholm A, Clementsen PF. Journal: Respiration. 2021;100(2):135-144. doi: 10.1159/000512074. Epub 2021 Jan 21. PMID: 33477141