Our Summary

This research paper is about a procedure called a percutaneous transthoracic lung biopsy (PTLB), which is a way to take a sample from a lung. Sometimes, people have what are called ‘cavitary lung lesions’, which are abnormal areas in the lungs that look like holes or cavities on a CT scan. These can be tricky to diagnose, and may need a biopsy to figure out what’s causing them.

Some researchers have suggested that doing a biopsy on a cavitary lung lesion might be more likely to cause a complication called a systemic air embolism (SAE). This is when an air bubble gets into the bloodstream and can block blood flow to important organs, which can be very dangerous.

The authors of this paper looked at previous research to see if there was evidence to support this idea. They found 10 case reports of SAE happening after a PTLB, and three studies that compared the rates of SAE after biopsies of cavitary lesions and non-cavitary lesions. They found that SAE happened in about 2.7% of biopsies of cavitary lesions and about 2.1% of biopsies of non-cavitary lesions. They calculated that the odds of SAE happening after a biopsy of a cavitary lesion were about 1.29 times the odds after a biopsy of a non-cavitary lesion.

However, none of the recent studies they looked at reported any deaths from SAE after a biopsy of a cavitary lesion.

The authors concluded that, based on the evidence they found, the rates of SAE are similar for biopsies of cavitary and non-cavitary lesions. They suggest that more research is needed to fully understand this issue.

FAQs

  1. What is a computed tomography-guided percutaneous transthoracic lung biopsy (PTLB)?
  2. Does a biopsy of a cavitary lung lesion pose a higher risk for systemic air embolism (SAE) than a noncavitary lesion?
  3. What were the results of the study comparing SAE in PTLB of cavitary and noncavitary lesions?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about lung biopsy is to follow all pre- and post-procedure instructions carefully. This may include avoiding food and drink for a certain period of time before the biopsy, taking any prescribed medications as directed, and following up with the doctor for any post-procedure care. It is also important to inform the doctor of any medications or medical conditions that may affect the procedure.

Suitable For

Patients with cavitary lung lesions are typically recommended for lung biopsy to obtain a confident diagnosis. This includes patients who have suspicious or concerning findings on imaging studies such as computed tomography (CT) scans. Additionally, patients who have failed to respond to conservative management or empiric therapy for their lung lesions may also be recommended for lung biopsy to guide further treatment. It is important to carefully evaluate each individual case and consider the risks and benefits of the procedure before recommending a lung biopsy.

Timeline

Before lung biopsy:

  • Patient presents with a cavitary lung lesion on imaging
  • Patient undergoes pre-biopsy evaluation and consultation with a healthcare provider
  • Patient may undergo imaging studies to determine the best approach for biopsy
  • Patient may receive instructions on fasting and medication management before the procedure

After lung biopsy:

  • Patient undergoes the percutaneous transthoracic lung biopsy (PTLB) procedure, guided by computed tomography
  • Patient may experience some discomfort or pain at the biopsy site
  • Patient is monitored for any complications, including systemic air embolism (SAE)
  • Patient may be discharged the same day or kept for observation depending on the clinical situation
  • Patient receives post-biopsy instructions for wound care and follow-up appointments

Overall, the timeline for a patient before and after a lung biopsy involves pre-biopsy evaluation, the biopsy procedure itself, and post-biopsy monitoring and care.

What to Ask Your Doctor

  1. What is the purpose of the lung biopsy in my case?
  2. What are the potential risks and complications associated with a lung biopsy, including systemic air embolism?
  3. How will the biopsy be performed, and what type of anesthesia will be used?
  4. How long will the procedure take, and will I need to stay in the hospital afterwards?
  5. What are the expected results and how soon will they be available?
  6. What are the alternatives to a lung biopsy in my situation?
  7. How will the biopsy results affect my treatment plan?
  8. What is the likelihood of complications, such as bleeding or infection, and how will they be managed?
  9. Are there any specific instructions or precautions I need to follow before or after the biopsy?
  10. Are there any specific factors, such as the presence of a cavitary lesion, that may increase the risk of systemic air embolism during the biopsy procedure?

Reference

Authors: Roberts JM, Chou FY, Byrne D, Sedlic A, Mayo JR. Journal: J Thorac Imaging. 2021 Jul 1;36(4):218-223. doi: 10.1097/RTI.0000000000000581. PMID: 33631775