Our Summary

This study looked at the complications that might occur when people with a certain type of lung disease (usual interstitial pneumonia or UIP) undergo a certain type of lung biopsy (percutaneous transthoracic needle biopsy or PTNB). The researchers were particularly interested in whether the presence of UIP findings on CT scans were associated with complications such as pneumothorax (a collapsed lung), pneumothorax requiring chest tube insertion, and coughing up blood (hemoptysis).

The study included 4,187 patients who had this type of biopsy between 2010 and 2015. Of these, 148 patients had UIP and the rest did not. In the UIP group, the researchers found that complications were more likely to occur when the biopsy needle passed through areas of the lung affected by UIP.

Specifically, those with UIP who had their biopsy needle pass through UIP findings were more likely to experience a pneumothorax and require a chest tube than those without UIP. However, if the biopsy needle did not pass through UIP findings, the risk of these complications was not higher than in those without UIP. Coughing up blood was not more common in the UIP group, regardless of whether the needle passed through UIP findings or not.

The takeaway from this study is that when doctors are performing this type of lung biopsy on patients with UIP, they should avoid passing the needle through areas of the lung affected by UIP whenever possible. This could help to reduce the risk of complications.

FAQs

  1. What complications might occur when patients with UIP undergo percutaneous transthoracic needle biopsy?
  2. Does the presence of UIP findings on CT scans increase the risk of complications during a lung biopsy?
  3. What is the recommended procedure for doctors performing this type of lung biopsy on patients with UIP?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient about lung biopsy, especially if they have UIP, is to make sure the biopsy needle does not pass through areas of the lung affected by UIP to lower the risk of complications such as pneumothorax. It is important for patients to discuss any concerns or questions they may have with their healthcare provider before undergoing the procedure.

Suitable For

Patients who are typically recommended for a lung biopsy include those with suspected lung cancer, suspected interstitial lung disease, suspected infections in the lungs, suspected autoimmune diseases affecting the lungs, and suspected sarcoidosis. Additionally, patients who have abnormal chest x-rays or CT scans showing lung nodules or masses may also be recommended for a lung biopsy to determine the cause of the abnormal findings.

Timeline

  • Before the lung biopsy: The patient undergoes a CT scan to identify the location of the abnormal tissue in the lung. The patient may also have blood tests and pulmonary function tests to assess lung function. The patient is informed about the procedure and potential risks.

  • During the lung biopsy: The patient is positioned on their back or side, and local anesthesia is administered to numb the area where the biopsy needle will be inserted. The biopsy needle is guided into the lung tissue using imaging techniques such as CT or ultrasound. Tissue samples are collected for analysis.

  • After the lung biopsy: The patient is monitored for a few hours to check for any immediate complications such as bleeding or pneumothorax. The patient may experience pain or discomfort at the biopsy site. Results from the biopsy are typically available within a few days to a week.

  • After the study: If the biopsy results show UIP findings, the patient may be at a higher risk for complications such as pneumothorax if the biopsy needle passed through areas of the lung affected by UIP. The patient may require additional monitoring or treatment, such as chest tube insertion, if complications arise. The patient’s healthcare provider will discuss the results and any necessary follow-up care.

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 associated with this type of biopsy?
  3. How will the doctor ensure that the biopsy needle avoids passing through areas of the lung affected by my condition (such as UIP)?
  4. How will pain and discomfort be managed during and after the biopsy procedure?
  5. What is the expected recovery time after the biopsy?
  6. Will I need any follow-up tests or appointments after the biopsy?
  7. Are there any specific instructions or restrictions I should follow before or after the biopsy procedure?
  8. How will the biopsy results be communicated to me, and what are the next steps in my treatment plan?
  9. Are there any alternative procedures or tests that could be considered instead of a lung biopsy?
  10. Can I get a second opinion from another specialist before proceeding with the biopsy?

Reference

Authors: Park J, Lee JH, Hong W, Hwang EJ, Yoon SH, Goo JM, Park CM. Journal: AJR Am J Roentgenol. 2024 Feb;222(2):e2329938. doi: 10.2214/AJR.23.29938. Epub 2023 Nov 1. PMID: 37910039