Our Summary

This research studied the risks involved in a type of lung biopsy procedure, called fluoroscopic-guided transbronchial lung biopsy (FG-TBLB). The study looked at data from 157 patients who underwent this procedure, specifically focusing on the risk of a specific complication called pneumothorax, where air gets into the space between the lung and the chest wall, causing the lung to collapse.

The study found that this complication occurred in about 7.6% of patients, most of whom needed additional treatment involving a chest tube to remove the air. The study also found that the risk was higher for women and for biopsies taken from the upper lobe of the lung.

The researchers concluded that while the overall risk of pneumothorax is low, doctors should be cautious when performing this procedure, especially in the upper lobe of the lung. They suggest that doctors should consider other biopsy locations if possible and should plan and prepare to minimise the risk of pneumothorax.

FAQs

  1. What is a fluoroscopic-guided transbronchial lung biopsy (FG-TBLB)?
  2. What is the risk of pneumothorax in FG-TBLB and how is it treated?
  3. Why should doctors be cautious when performing this procedure in the upper lobe of the lung?

Doctor’s Tip

A doctor may advise a patient undergoing a lung biopsy to discuss the risks and benefits of the procedure with their healthcare provider. They may also recommend following any pre-procedure instructions, such as fasting or stopping certain medications, to reduce the risk of complications. Additionally, they may suggest arranging for transportation to and from the appointment, as well as having a support person available to assist after the procedure. It’s important for patients to communicate any concerns or questions they may have with their healthcare team to ensure a safe and successful biopsy.

Suitable For

Patients who are typically recommended for a lung biopsy include those with suspected lung cancer, interstitial lung disease, pulmonary nodules or masses, infections such as tuberculosis or fungal infections, and other lung conditions that require further evaluation. Additionally, patients who have had inconclusive results from other diagnostic tests such as imaging studies or bronchoscopy may also be recommended for a lung biopsy to obtain a definitive diagnosis.

Timeline

Before the lung biopsy:

  • Patient is referred to a specialist for further evaluation of lung abnormalities
  • Specialist reviews medical history, performs physical exam, and orders imaging tests (e.g. CT scan) to determine the need for a lung biopsy
  • Patient undergoes pre-procedure tests (e.g. blood tests, chest x-ray) to assess overall health and suitability for the procedure
  • Patient receives instructions on fasting, medication adjustments, and other pre-procedure preparations

During the lung biopsy:

  • Patient is given local anesthesia to numb the area where the biopsy will be taken
  • Fluoroscopic guidance is used to help the doctor locate the abnormal tissue in the lung
  • A thin needle or biopsy forceps is inserted through the mouth or nose and into the lung to collect tissue samples
  • The procedure usually takes about 30-60 minutes and is generally well tolerated by patients

After the lung biopsy:

  • Patient is monitored for a few hours to ensure there are no immediate complications (e.g. bleeding, breathing difficulties)
  • Patient may experience mild discomfort, coughing, or bloody sputum for a few days after the procedure
  • Results of the biopsy are sent to the specialist for analysis and further treatment planning
  • Patient follows up with the specialist for discussion of biopsy results and any necessary follow-up care or treatment.

What to Ask Your Doctor

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

  1. What type of lung biopsy procedure will be performed?
  2. What are the potential risks and complications of the procedure, including the risk of pneumothorax?
  3. Are there any specific factors that may increase my risk of developing complications, such as my gender or the location of the biopsy?
  4. How will the doctor minimise the risk of pneumothorax during the procedure?
  5. What symptoms should I watch for after the biopsy that may indicate a complication, such as pneumothorax?
  6. What follow-up care will be needed after the biopsy, and what should I do if I experience any complications?
  7. Are there any alternative biopsy methods that may be less risky for me?
  8. How experienced is the doctor in performing this type of biopsy procedure?
  9. What is the success rate of the biopsy in obtaining a sufficient tissue sample for diagnosis?
  10. Are there any specific instructions I should follow before or after the biopsy to ensure a successful outcome?

Reference

Authors: Ng BH, Low HJ, Nuratiqah NA, Soo CI, Imree A, Mas FMJ, Azat AA, Faisal AH, Andrea BYL. Journal: Med J Malaysia. 2023 Dec;78(7):897-900. PMID: 38159925