Open lung biopsy

Alternative names
Biopsy - open lung

Open lung biopsy is a test in which a small piece of the lung tissue is removed through a surgical incision in the chest. The sample is then examined for cancer, infection, or lung diseases.

How the test is performed

The open lung biopsy is done in a hospital operating room under general anesthesia (while you are unconscious and pain-free). Throughout the procedure, you are given a mixture of anesthetic gas and oxygen through a tube that is inserted through the mouth and into the airway that leads to the lungs.

The skin is cleansed and an incision is made over the area to be sampled. A small piece of the lung tissue is removed. The incision is then stitched closed.

A chest tube may be left in place for 1 to 2 days to prevent the lung from collapsing.

How to prepare for the test

Inform the health care provider if you are pregnant, if you have allergies to any medication, which medications you are taking (including any herbal preparations), and if you have a bleeding problem.

You must sign a consent form. You will be asked not to eat or drink for 8 to 12 hours before the biopsy.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child’s age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child’s age:

  • Infant test or procedure preparation (birth to 1 year)  
  • Toddler test or procedure preparation (1 to 3 years)  
  • Preschooler test or procedure preparation (3 to 6 years)  
  • Schoolage test or procedure preparation (6 to 12 years)  
  • Adolescent test or procedure preparation (12 to 18 years)

How the test will feel
When you wake up after the procedure, you will feel drowsy for several hours. You may have a mild sore throat from the tube. You will feel some discomfort and pain at the incision site.

Why the test is performed

The open lung biopsy is done to evaluate abnormalities detected by X-ray or CT scan.

This procedure is usually used after other tests have been inconclusive.

Normal Values
The lung tissue will be uniform in texture, and the structure is normal.

What abnormal results mean
Abnormal results may indicate cancer, benign tumors, lung diseases, and certain infections.

Additional conditions under which the test may be performed:

  • Acute pulmonary eosinophilia (Loeffler’s syndrome)  
  • Chronic pulmonary coccidioidomycosis  
  • Disseminated coccidioidomycosis  
  • Disseminated tuberculosis (infectious)  
  • Chronic pulmonary histoplasmosis  
  • Mesothelioma (benign-fibrous)  
  • Mesothelioma (malignant)  
  • Pneumonia with lung abscess  
  • Primary lung cancer  
  • Pulmonary aspergillosis  
  • Pulmonary tuberculosis  
  • Rheumatoid lung disease  
  • Sarcoidosis  
  • Viral pneumonia  
  • Wegener’s granulomatosis

What the risks are
There is a possibility of infection or an air leak into the chest. How great the risk is depends on the pre-existing lung disease.

Johns Hopkins patient information

Last revised: December 3, 2012
by Gevorg A. Poghosian, Ph.D.

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