Our Summary

This study looked at the factors that might increase the risk of a lung collapsing (pneumothorax) during a type of biopsy (a medical test where a small bit of tissue is removed for examination) guided by a CT scan. The researchers analyzed the data of 671 patients who had undergone this procedure.

They found that there was a 26.7% chance of pneumothorax occurring. Certain factors increased this risk. These included where the needle was inserted (either at the front or side of the pleural surface, which is the membrane that surrounds the lungs), if the needle had to pass through more than one pleural surface, and the patient’s position during the procedure. If the patient was laid on their back or on their side with the nodule (the lump being examined) facing up, the risk was higher.

Another risk factor was the presence of emphysema (a lung disease that causes shortness of breath) in the path of the biopsy needle. This was the factor that most strongly increased the risk of pneumothorax.

However, the researchers also found that a higher body mass index (BMI) and a larger nodule reduced the risk of pneumothorax.

The main takeaway is that emphysema in the path of the needle biopsy increases the risk of lung collapse, while a higher BMI and a larger nodule can reduce this risk.

FAQs

  1. What factors increase the risk of a lung collapsing during a CT-guided lung biopsy?
  2. How do a higher body mass index (BMI) and a larger nodule affect the risk of pneumothorax during a lung biopsy?
  3. Why does the presence of emphysema in the path of the biopsy needle increase the risk of pneumothorax?

Doctor’s Tip

Therefore, it’s important for your doctor to carefully consider these factors when planning your lung biopsy procedure. Additionally, make sure to follow any pre-procedure instructions given to you by your healthcare provider to help minimize any potential risks. If you have any concerns or questions, don’t hesitate to discuss them with your doctor before the biopsy.

Suitable For

Patients who are recommended for a lung biopsy typically include those with suspicious lung nodules or masses that need to be examined for cancer or other diseases, those with unexplained lung abnormalities or infections, and those with lung diseases such as interstitial lung disease or pulmonary fibrosis. Additionally, patients who are at a higher risk for lung cancer, such as smokers or those with a family history of lung cancer, may also be recommended for a lung biopsy.

Timeline

Before the lung biopsy:

  1. Patient is referred for a lung biopsy to investigate a suspicious nodule or mass in the lung.
  2. Patient undergoes imaging tests such as a CT scan to locate the nodule and determine the best approach for the biopsy.
  3. Patient may undergo blood tests and other pre-operative evaluations to assess their overall health and fitness for the procedure.
  4. Patient may receive instructions on fasting before the procedure and any medications to avoid.

During and after the lung biopsy:

  1. Patient is positioned on a table and given local anesthesia to numb the area where the biopsy needle will be inserted.
  2. The biopsy needle is guided into the lung using imaging techniques such as CT scan or ultrasound.
  3. Small samples of tissue are taken for examination.
  4. After the procedure, the patient is monitored for any complications such as pneumothorax (lung collapse), bleeding, or infection.
  5. Patient may experience some pain or discomfort at the biopsy site, which can be managed with pain medications.
  6. Results of the biopsy are usually available within a few days to a week, and the patient may need to follow up with their doctor to discuss the findings and any further treatment options.

What to Ask Your Doctor

Here are some questions a patient should consider asking their doctor about a lung biopsy:

  1. What are the potential risks and complications of a lung biopsy, including the risk of pneumothorax?
  2. Are there any specific factors in my case that may increase the risk of a lung collapse during the biopsy procedure?
  3. How will my position during the biopsy procedure affect the risk of pneumothorax?
  4. How does the presence of emphysema in my lungs impact the risk of a lung collapse during the biopsy?
  5. Will my body mass index or the size of the nodule being biopsied play a role in the risk of pneumothorax?
  6. Are there any steps that can be taken to reduce the risk of a lung collapse during the biopsy procedure?
  7. What should I expect after the biopsy in terms of monitoring for pneumothorax and managing any potential complications?
  8. What are the alternative options for diagnosing my condition if a lung biopsy is deemed too risky?
  9. Are there any specific precautions or instructions I should follow before and after the biopsy to minimize the risk of pneumothorax?
  10. How often do pneumothorax complications occur in patients who undergo lung biopsies at this facility, and what is the standard protocol for managing these complications?

Reference

Authors: Sargent T, Kolderman N, Nair GB, Jankowski M, Al-Katib S. Journal: J Bronchology Interv Pulmonol. 2022 Jul 1;29(3):198-205. doi: 10.1097/LBR.0000000000000816. Epub 2021 Oct 14. PMID: 34654044