Definition

An open lung biopsy is surgery to remove a small piece of tissue from the lung. The sample is then examined for cancer, infection, or lung disease.

Alternative Names

Biopsy - open lung

How the Test is Performed

An open lung biopsy is done in the hospital using general anesthesia. This means you will be asleep and pain free. A tube will be placed through your mouth down your throat, and into your windpipe (trachea) to help you breathe.

The surgery is done in the following way:

• After cleaning the skin, the surgeon makes a small cut in the left or right side of your chest.
• The ribs are gently separated.
• A viewing scope may be inserted through a small hole between the ribs to see the area to be biopsied.
• Tissue is taken from the lung and sent to a lab for examination.
• After surgery, the wound is closed with stitches.
• Your surgeon may leave a small plastic tube in your chest to prevent air and fluid from building up.

The breathing tube may not be able to be removed right after surgery. So, you may need to be on a breathing machine for some time.

How to Prepare for the Test

You should tell your surgeon if you are pregnant, allergic to any medicines, or if you have a bleeding problem. Be sure to tell your surgeon about all the medicines you take, including herbs, supplements, and those bought without a prescription.

Follow your surgeon's instructions for not eating or drinking before the procedure.

How the Test will Feel

When you wake up after the procedure, you will feel drowsy for several hours.

There will be some tenderness and pain where the surgical cut is located. Most surgeons inject a long-acting local anesthetic at the surgical cut site so that you will have very little pain right afterward.

You may have a sore throat from the tube. You can ease the pain by eating ice chips.

Why the Test is Performed

The open lung biopsy is done to evaluate lung problems seen on x-ray, CT scan, or other imaging tests of the lung.

Normal Results

The lungs and lung tissue will be normal.

What Abnormal Results Mean

Abnormal results may be due to:

• Benign (not cancerous) tumors
• Cancer
• Certain infections (bacterial, viral, fungal, or parasitic)
• Lung diseases (fibrosis)

The procedure may help diagnose a number of different conditions, such as:

• A group of lung problems related to rheumatoid arthritis (rheumatoid lung disease)
• Inflammation that affects the lungs and other body tissues (sarcoidosis)
• Inflammation of the blood vessels (granulomatosis with polyangiitis)
• High blood pressure in the arteries of the lungs (pulmonary hypertension)

Risks

There is a slight chance of:

• Air leak
• Excess blood loss
• Infection
• Injury to the lung
• Collapsed lung (pneumothorax)

References

Spahr J, Weiner DJ, Stokes DC, Kurland G. Pulmonary disease in the immunosuppressed pediatric patient. In: Bush A, Deterding R, Li AM, eds. Kendig and Wilmott's Disorders of the Respiratory Tract in Children. 10th ed. Philadelphia, PA: Elsevier; 2024:chap 54.

Wald O, Izhar U, Sugarbaker DJ. Lung, chest wall, pleura, and mediastinum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 58.