Our Summary

Asthma is a complicated disease with many different types, especially severe asthma. It’s important to identify these different types so that doctors can give patients the best treatment possible. This paper talks about the role of lung biopsies in diagnosing severe asthma and guiding treatment. Lung biopsies, which involve taking a small sample of lung tissue, can give us information about the different types of asthma, which can help improve patient outcomes. However, it’s not clear if these biopsies always provide new information that couldn’t be gotten another way. Whether or not a lung biopsy should be done on a patient with severe asthma is a decision that needs to be made on a case-by-case basis. This paper provides an overview of what we can learn from lung biopsies in severe asthma, but it’s largely based on the authors’ personal experiences because there isn’t a lot of data on this topic.

FAQs

  1. What is the role of lung biopsies in diagnosing severe asthma?
  2. Does a lung biopsy always provide new information about a patient’s asthma that couldn’t be obtained through other methods?
  3. How is the decision made to perform a lung biopsy on a patient with severe asthma?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung biopsy is that it is a minimally invasive procedure that can provide important information about the underlying cause of lung problems. The doctor may explain that the biopsy will help determine if there are any abnormalities in the lung tissue, such as inflammation or scarring, which can guide treatment decisions. They may also mention that the procedure is usually done under local anesthesia and that there may be some discomfort or soreness afterwards, but it is generally well tolerated. It is important for the patient to follow any pre-procedure instructions given by the doctor and to inform them of any medications or health conditions they have prior to the biopsy. Additionally, the doctor may discuss the risks and benefits of the procedure with the patient to ensure they are fully informed before proceeding.

Suitable For

Patients who are recommended for a lung biopsy typically include those with severe asthma that is difficult to control with standard treatments. These patients may have persistent symptoms, frequent exacerbations, and poor lung function despite optimal therapy. Additionally, patients with atypical or uncommon presentations of asthma, such as those with eosinophilic or neutrophilic inflammation, may also be candidates for a lung biopsy.

Other patients who may be recommended for a lung biopsy include those with suspected interstitial lung disease, lung nodules or masses, pulmonary infections, or suspected lung cancer. In these cases, a lung biopsy can help to determine the underlying cause of the patient’s symptoms and guide appropriate treatment.

Overall, the decision to recommend a lung biopsy for a patient is based on the individual’s symptoms, medical history, and the suspected underlying cause of their lung disease. It is important for healthcare providers to carefully weigh the risks and benefits of a lung biopsy and ensure that the procedure is necessary to provide a definitive diagnosis and guide treatment decisions.

Timeline

Before the lung biopsy:

  1. The patient may be experiencing symptoms of severe asthma, such as frequent exacerbations, difficulty breathing, and chest tightness.
  2. The doctor may recommend a lung biopsy to further investigate the underlying cause of the patient’s symptoms.
  3. The patient will likely undergo several tests and evaluations to assess their lung function and overall health before the biopsy procedure.

During the lung biopsy:

  1. The patient will be given anesthesia to numb the area where the biopsy will be taken.
  2. The doctor will use a needle or other tool to extract a small sample of lung tissue for analysis.
  3. The procedure may take anywhere from 30 minutes to an hour, depending on the complexity of the biopsy.

After the lung biopsy:

  1. The patient may experience some pain or discomfort at the biopsy site, which can usually be managed with over-the-counter pain medications.
  2. The extracted lung tissue will be sent to a lab for analysis, which can take several days to weeks to receive the results.
  3. Once the results are available, the doctor will discuss the findings with the patient and determine the best course of treatment based on the biopsy results.

What to Ask Your Doctor

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

  1. Why do you recommend a lung biopsy for my severe asthma?
  2. What information do you hope to gain from the lung biopsy?
  3. What are the risks and potential complications associated with a lung biopsy?
  4. How will the lung biopsy be performed?
  5. Will I need to be hospitalized for the procedure?
  6. How long will it take to get the results of the biopsy?
  7. How will the results of the biopsy impact my treatment plan for severe asthma?
  8. Are there alternative diagnostic tests that could provide similar information without the need for a biopsy?
  9. How experienced is the medical team in performing lung biopsies for severe asthma?
  10. Are there any specific instructions or precautions I need to follow before and after the lung biopsy procedure?

Reference

Authors: Doberer D, Trejo Bittar HE, Wenzel SE. Journal: Eur Respir Rev. 2015 Sep;24(137):525-39. doi: 10.1183/16000617.0045-2015. PMID: 26324815