A lung biopsy is a diagnostic procedure that involves obtaining biological samples of lung tissue.
Subsequently, these tissues are examined for pathological abnormalities. Most often, a pulmonary biopsy is performed to exclude oncoprocesses in the lungs.
Indications and contraindications
Pulmonary biopsy is usually prescribed when a large volume of formation is detected in the patient's lung, which can be caused by pathologies such as cancer, sarcoidosis, abscess, tuberculosis, protracted pneumonia, alveolitis, benign tumors, etc.
The procedure is contraindicated for people who have diseases like:
- Pulmonary cyst;
- Problems with blood coagulability;
- Pulmonary hypertension;
- Pronounced anemia;
- Chronic myocardial insufficiency in the decompensated stage.
In other cases, there is no contraindication for this diagnostic procedure.
Pulmonary biopsy can be performed in several ways: transbronchial, puncture, open or thoracoscopic.
Transbronchial lung biopsy is considered quite popular, it involves the use of a bronchoscope. This method of sampling biomaterial is widely used in determining infectious pathologies and in detecting abnormal growths adjacent to the bronchi.
Bronchoscopy visualizes the surface of the respiratory tract and allows you to take a piece of tissue in any of their areas. The duration of such a diagnostic event can be up to an hour, although more often it takes 30 minutes.
Indications for conducting a transbronchial pulmonary biopsy are pathologies like:
- ; carcinomatosis;
- Alveolitis and other pulmonary lesions are diffuse.
This technique assumes carrying out of an endoscopic reception of a biopsy through a puncture of a bronchial wall. During the procedure, forceps are injected into various bronchial departments, taking up to 7 samples from individual sites.
The procedure is usually carried out under the control of the X-ray machine, which ensures the accuracy of the procedure. There are cases when after transbronchial pulmonary biopsy patients bleed and pneumothorax.
This method of obtaining a biopsy from the lungs involves the use of a long hollow needle, which is the aim of obtaining tissue from the desired site.
As a result, the doctor receives a cellular bio-sample of tissue structures located in close proximity to the thorax.
The results of such a study patient have to wait 10-14 days.
A needle-trocar or Silverman is usually used for a puncture biopsy. The possibilities of puncture pulmonary biopsy are somewhat limited, because it is not always possible to get to the necessary site from which it is necessary to obtain a sample.
Although there is a method, if it is informative, and its advantages - a puncture biopsy eliminates the need for diagnostic thoracotomy.
In addition, the procedure allows you to carefully plan the operation flow, access options, body removal volumes, which is very important for patients who have high operational risks.
An open method for conducting a pulmonary biopsy involves surgery, during which the doctor cuts out a microscopic piece of biomaterial from the desired site. In the pulmonary zone, a surgical incision is made, through which access to the tissues is ensured.
The patient is provided with endotracheal anesthesia, then a 8-12 cm incision is made slightly below the armpit in 4-5 hypochondrium. The patient lies on his side. Seized bio-samples are tested for the presence of pulmonary infections, cancer and other probable lesions.
The open technique for obtaining a biopsy specimen from lung tissue allows to accurately determine the presence of pathologies like granulomatosis, sarcoidosis, rheumatoid pathologies, etc.
The method of videotorakoscopic biopsy is the most informative and diagnostically accurate for today.
There are several small incisions between the ribs on the side of the affected lung, through which the camera and miniature instruments are inserted.
The procedure is not very invasive, and unlike the open method it does not need a long rehabilitation.
Videotoracoscopic technique is considered quite expensive, so it is available mainly in private clinics, because it requires the availability of expensive equipment.
Before carrying out the procedure, the doctor necessarily explains to the patient the possible risks and complications, collects information on the presence of allergy, medication, pregnancy and blood pathologies.
- It is recommended to give up food 6 hours before taking a biopsy.
- Do not take Aspirin, Warfarin and other drugs that help to thin the blood.
- Patient needs to remove jewelry, dentures, lenses, etc.
How is a lung biopsy done?
If a biopsy is performed using a bronchoscope, the device is inserted through the mouth or nose.
This procedure is more effective in the presence of non-severe signs like hemoptysis or chronic cough.
If the biopsy is puncture, the procedure is controlled by X-ray or ultrasound equipment.
A puncture biopsy is performed with local anesthesia, and an open or videotorakoscopic biopsy is performed under general anesthesia.
Moreover, when performing the latter type of biopsy, the device for artificial pulmonary ventilation is additionally used.
Sarcoidosis is a connective tissue pathology in which nodules are formed on the lungs. For an accurate diagnosis, it is necessary to perform a bronchoscopy, during which the biomaterial is taken for histology.
Pulmonary biopsy in sarcoidosis is a very significant procedure. Based on the results of the biopsy histology, the doctor more fully composes the clinical picture of the pathology and prescribes the most optimal treatment.
In case of cancer of
In pulmonary carcinoma, bronchoscopy and biopsy of lung tissues are crucial in the diagnosis and choice of further treatment.
A transbronchial puncture biopsy of the lymph nodes allows one to determine the prevalence of the cancer process.
- With central pulmonary cancer, bronchoscopy with perebronchial puncture biopsy is indicated.
- In peripheral pulmonary cancer, the optimal diagnosis is percutaneous puncture biopsy with tomographic control.
Aspiration needle biopsy in the case of pulmonary cancer is used to determine the histological character of tumors located on the periphery adjacent to the breast cell wall.
Such a procedure should be performed only by a highly qualified diagnostician, because there is a possibility of forming implantation metastases, formed during the biopsy needle, or air embolism.
Results of lung biopsy
The results of the study are usually ready in 3-5 days. If the analysis is extended, then the result can be expected and 2 weeks.
When deciphering the received information, normal results are considered if there are no infectious processes of fungal, bacterial or viral origin, cancer cells, fibrotic and pneumonic foci, and also benign formations.
One of the most common complications of lung biopsy is collapse( or pneumothorax).
To prevent such a complication, after biopsy diagnosis it is recommended that the patient be given an X-ray examination, during which the patient's pulmonary system will be clearly understood.
To eliminate this condition, it is necessary to insert a drainage tube that will release excess air from the chest and help to break down the lung tissue.
Consequences of pulmonary biopsy may also occur with intense bleeding that requires specialist intervention. Therefore, for several days the patient is desirable to observe in the hospital.
I'm a terrible coward, so when I was prescribed bronchoscopy with a biopsy, I just hit my panic. Therefore, advice - tune in immediately, which will not hurt. This I did not immediately know that the procedure was painless, so I was afraid. I immediately all lidocaine zashikali, then at certain intervals of time added a dose of anesthetic. It did not hurt at all, and there were no complications. But after the investigation, the diagnosis was accurately determined. Therefore, although the procedure is unpleasant, it is extremely informative.
I am a smoker with many years of experience, so when there was shortness of breath, hemoptysis and other unpleasant symptoms, I was afraid that everything - was getting used up. I went to the doctor, found a suspicious site on the radiograph and received a biopsy. I try to avoid doctors, but here it is. Among all the proposed options I stopped on puncture biopsy, the benefit of the most non-invasive procedure. Everything went better than I thought, the consequences were also avoided. Analyzes excluded cancer, but the problem with the lungs still found. Therefore, I think that the biopsy procedure in my case was very useful and helped to determine the correct diagnosis in a timely manner.
The price of the procedure and where can I go through it?
- The average cost of a puncture pulmonary biopsy in the clinics of the capital is about 1750-9800 rubles.
- Transbronchial biopsy will cost 1500-7900 rubles.
Passing the procedure of pulmonary biopsy is better in highly qualified clinics of the republican, regional or metropolitan scale. Only in such medical institutions there is the necessary equipment and qualified staff able to conduct the procedure without undesirable consequences for the patient.
Video on transbronchial lung biopsy: