Lung or chest needle biopsy – fine needle aspiration

What is a lung or chest needle biopsy?

A needle biopsy is used to take samples of lumps or growths in the lung or other tissues in the chest, such as lymph nodes or the lining of the lungs.

This is called a percutaneous transthoracic fine needle aspiration (FNA).

A CT scanner, X-ray or ultrasound machine is used to guide a small needle through the skin and into the lump or growth.

Benefits of a needle biopsy

• Used instead of surgery to obtain a diagnosis.
• Used to see how far the disease has spread before surgery or other treatment.

Risks of a needle biopsy

Your doctor knows the risks of a needle biopsy and will advise you whether the benefits outweigh any possible risk. Possible risks are:

• Pneumothorax (air around the lung) – this may need treatment with a tube in the chest.
• Cannot see the area around the lump or growth. Other problems may be missed because of this.
• Small risk of infection or bleeding.
• You may cough up some blood during the procedure. This usually stops soon afterwards.
• Not being able to get a large enough sample to make a diagnosis.

Preparation

• Bring your referral letter or request form and all X-rays taken in the last 2 years with you.
• Leave the X-rays with the radiology staff as the doctor may need to look at them. The radiology staff will tell you when these are ready to be picked up.
• Leave all jewellery and valuables at home.
• You will be admitted to hospital as a day patient.
• You will be asked not to eat food or drink milk for a few hours before the test. Clear fluids are okay to drink.
• You will be asked not to drink water for 2 to 4 hours before the test.

Just before the procedure:

• You may be given a gown to wear.
• You may be asked to remove any metal objects.
• You may be given a tablet to relax you (sedative).

Tell your doctor before the procedure

• If you are or may be pregnant.
• If you are on any blood thinning medication (Warfarin, regular aspirin, clapidrogrel).
• If you have diabetes.
• If you are planning air travel soon afterwards.

What happens during a needle biopsy

You will be asked to either sit or lie down depending on why you are having the procedure. Staff will clean the skin where you are having the biopsy and place sterile drapes over you. They will sometimes inject a local anaesthetic into the skin, but not always.

The radiology doctor will use X-ray, CT or ultrasound to guide them while they put a needle into the lump or area they are looking at. They will use the needle to take a sample (biopsy) of the area. You will feel a slight pressure but this should not hurt.

The biopsy usually takes about 30 minutes to 1 hour, including time taken to get ready.

Consent

You have the right to refuse an examination and may do so if you wish. You will be asked to fill in a consent form.

When will I get the results?

The amount of time it takes for you to get your results will differ depending on where you get your scans done. The radiology doctor will look at the pictures and write a report. The pictures may be on films or on a CD.

Ask whether you should wait to take the pictures and report with you, or whether they will be sent to your doctor.

Your doctor will need to discuss the report with you. You will need to make an appointment to do this.

After a needle biopsy

• You will usually have a chest X-ray straight after the procedure and then 3 to 4 hours afterwards to check for pneumothorax.
• You will be taken to a recovery area on a stretcher.
• Staff will check your heart rate and blood pressure a few times.
• Staff will give you any special instructions.

If you had a sedative:

• You must not drive a car or take public transport for 24 hours afterwards.
• You must have someone with you for 24 hours afterwards.
• You must not operate machinery for the rest of the day.

Costs of a needle biopsy

For an Australian patient in a public hospital in Western Australia:

• public patient – no cost to you unless advised otherwise
• private patient – costs can be claimed through Medicare and your health insurance provider

For a patient in a private hospital or private imaging site in Western Australia – ask your doctor or the staff where you are having your test done.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.