Our Summary

This study looked at what factors might predict a non-conclusive result from a specific type of lung biopsy, and what the final diagnosis was for those cases. The biopsy in question is performed with a needle through the chest wall, guided by a CT scan.

In the study, they reviewed all such biopsies over a 4-year period. They found that in about 17% of cases, the results were non-conclusive – they couldn’t confirm whether the lung lesions were cancerous or benign. Some of the factors that made it more likely to get a non-conclusive result were if the lesion was small, if the biopsy needle had to go through lung tissue affected by emphysema, if the needle didn’t actually go into the lesion, if the procedure took more than 60 minutes, or if there was bleeding in the air sacs of the lungs.

When they looked at the final diagnosis for those non-conclusive cases, they found that 36% turned out to be cancerous and 64% were benign. If the patient had a history of cancer, or if atypical cells were found in the biopsy sample, it was more likely that the lesion was cancerous.

So, in cases where the initial biopsy is non-conclusive, but there’s a history of cancer or atypical cells are seen, doctors might want to consider doing another biopsy or a surgical intervention.

FAQs

  1. What is the type of lung biopsy discussed in this study?
  2. What factors were found to make a non-conclusive result more likely in this type of lung biopsy?
  3. What was the final diagnosis for non-conclusive lung biopsy cases in this study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung biopsy is to be aware that there is a chance of getting a non-conclusive result. It’s important to discuss this possibility with your healthcare provider beforehand and understand what the next steps may be if that happens. Additionally, make sure to follow up with your doctor for further testing or treatment as needed based on the final diagnosis.

Suitable For

Patients who are typically recommended for a lung biopsy include those with suspicious lung nodules or masses found on imaging studies such as chest X-rays or CT scans, patients with symptoms such as coughing up blood, unexplained weight loss, or persistent cough, patients with a history of lung cancer or other cancers that may have spread to the lungs, and patients with lung infections or inflammatory conditions that are not responding to treatment.

In addition, patients who are at high risk for developing lung cancer, such as smokers or individuals with a family history of lung cancer, may also be recommended for a lung biopsy to rule out cancer. Overall, the decision to recommend a lung biopsy is typically made by a multidisciplinary team of healthcare providers, including pulmonologists, oncologists, radiologists, and pathologists, based on the patient’s individual risk factors and clinical presentation.

Timeline

Before the lung biopsy, the patient may have symptoms such as coughing, shortness of breath, chest pain, or abnormal imaging results that lead to the decision to perform the biopsy. The patient will likely undergo imaging tests such as a chest X-ray or CT scan to locate the lesion in the lung. They may also have blood tests to assess their overall health and check for any underlying conditions.

During the lung biopsy procedure, the patient will be given local anesthesia to numb the area where the biopsy needle will be inserted. They may also receive sedation to help them relax during the procedure. The biopsy needle is guided into the lung lesion using a CT scan for precision. Tissue samples are then collected for examination in the lab.

After the lung biopsy, the patient will be monitored for any complications such as bleeding or infection. They may experience some pain or discomfort at the biopsy site, which can be managed with over-the-counter pain medication. The tissue samples will be sent to a pathologist for analysis, and the patient will typically receive the results within a few days to a week.

If the biopsy results are non-conclusive, further testing or procedures may be needed to determine the nature of the lung lesion. This may include repeat biopsies, imaging tests, or even surgery to remove the lesion for a definitive diagnosis. Depending on the final diagnosis, the patient will be provided with appropriate treatment options such as surgery, chemotherapy, or radiation therapy for cancerous lesions, or monitoring and follow-up for benign lesions.

What to Ask Your Doctor

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

  1. What type of lung biopsy is being recommended and why?
  2. What are the risks and potential complications of the procedure?
  3. What factors might increase the likelihood of a non-conclusive result?
  4. How will the biopsy sample be analyzed and how long will it take to receive the results?
  5. What are the potential next steps if the initial biopsy results are non-conclusive?
  6. How will the final diagnosis impact treatment options and prognosis?
  7. Are there alternative diagnostic tests or procedures that could provide more definitive results?
  8. What is the experience of the healthcare team performing the biopsy?
  9. What is the recovery process like after a lung biopsy?
  10. Are there any specific instructions or precautions to follow before and after the procedure?

Reference

Authors: Tongbai T, McDermott S, Kiranantawat N, Muse VV, Wu CCC, Shepard JAO, Gilman MD. Journal: Korean J Radiol. 2019 Nov;20(11):1515-1526. doi: 10.3348/kjr.2019.0014. PMID: 31606956