lung biopsy
Meaning of lung biopsy: The step that converts a shadow on a scan into a name, and the point at which treatment can finally be planned.
Definition of lung biopsy
A lung biopsy is the removal of a small piece of lung tissue so it can be examined under a microscope. It answers questions that scans cannot: whether a shadow is cancer, an infection or scarring, and if cancer, which type. Several routes exist, from a needle passed through the chest wall to an operation, and the choice depends on where the abnormality sits.
Which routes are used?
| Route | How it reaches the tissue | Suited to |
|---|---|---|
| Bronchoscopic | Instrument passed down the airways | Lesions near the large airways |
| Needle through the chest wall | Guided by CT scanning | Lesions near the outer surface |
| Keyhole surgery | Camera and instruments between the ribs | Larger samples, uncertain diagnoses |
| Open surgery | An incision between the ribs | When other routes fail or are unsafe |
A bronchoscope is a thin flexible tube carrying a light and camera, passed through the nose or mouth, down the windpipe and into the airways. Ultrasound built into its tip allows sampling of lymph nodes sitting outside the airway wall, which is how the spread of a tumor is often checked at the same sitting.
What does the sample show?
A pathologist examines the tissue and answers several questions at once: whether the cells are malignant, what type they are, and how far they have departed from normal. Further tests on the same material look for the genetic changes that decide whether a targeted drug is an option. Not every finding is cancer. Infection, inflammation and scarring have appearances of their own, and a biopsy is frequently done precisely to separate them.
What can go wrong?
Air leaking from the lung into the space around it is the main complication of a needle passed through the chest wall, common enough that a chest x-ray is taken afterward to look for it. Bleeding is the other, usually slight. A sample can also miss its target or be too small to answer the question, in which case the biopsy may be repeated by a different route.
Also known as
Used in a sentence
A CT-guided lung biopsy was arranged to sample the right upper lobe nodule.
Good to know
A biopsy showing no cancer is not always reassuring, because a needle can miss a small target, so the result is read alongside the imaging rather than on its own.
Word origin
Where “lung biopsy” comes from
Biopsy joins the Greek bios, meaning life, with opsis, meaning sight, so the word describes examining tissue taken from the living body.