Lung biopsy

A lung biopsy is when a specialist doctor takes a small sample of tissue or cells from your lungs for testing.

Your GP or specialist may refer you for a lung biopsy to find out what’s causing your symptoms. Lung biopsies can help diagnose lots of different lung conditions, such as interstitial lung diseases, cancer, and infections like tuberculosis.

Your healthcare professional will explain how they will do the lung biopsy, how you need to prepare, and if there are any risks. 

A lung biopsy is usually done in hospital. The hospital will send you a letter with instructions and an information sheet about the test and possible risks. Read these carefully so you know what to do before the test.

The letter should tell you if you:

• can eat before the test, or if you need to avoid food for a few hours – you may be told to only have a light breakfast
• can keep taking your prescribed medicines, or if you need to stop taking them – you may need to stop taking blood thinning medicines like warfarin before the test, for example
• need to bring an overnight bag to your appointment in case you need to stay in hospital.

There are different types of lung biopsy test. Your appointment letter will explain which type you are having, and how long your appointment will be.

Before the test

Your healthcare professional will explain the risks and benefits. You can also ask any questions to make sure you’re happy with everything before you sign a consent form.

A nurse or other healthcare professional will check your blood pressure, heart rate, breathing rate, oxygen level, and weight.

During the test

A nurse or other healthcare professional will continue to check your oxygen levels and heart rate during the test, using a clip on your finger.

For some lung biopsies, you can have a local anaesthetic. A local anaesthetic is when you stay awake for the procedure, but the area is numbed so you don’t feel any pain.

For other types you’ll need a general anaesthetic. This is where you’re given medicine to sleep, so you don’t feel anything during the procedure.

A CT-guided needle biopsy

This is also called a percutaneous needle biopsy. It’s when a thin needle is inserted through the skin into the lung, guided by a CT scan or ultrasound.

You may feel some pressure from the biopsy needle as it takes the sample, but it usually does not hurt. You will usually have a local anaesthetic.

A bronchoscopy biopsy

You might have a biopsy using a bronchoscope. This is a long, thin tube with a tiny camera on the end.

The tube is passed through your nose or mouth and down into your lungs to take a sample. A combination of sedation medicine to help you relax and local anaesthetic can make the test as comfortable as possible.

Find out more about bronchoscopy and how this test can help healthcare professionals see inside your airways and lungs.

Surgical lung biopsy

You’ll need a general anaesthetic for a surgical lung biopsy. You may have keyhole surgery which means surgeons only need to make a very small cut. Or you may have open surgery.

• Video assisted thoracoscopy (VATS) is when a small camera called a thoracoscope is inserted into a small cut in your chest. The camera shows live images on the computer screen.
• Open lung biopsy is when a surgeon makes a larger cut in the side of your chest so they can operate on your lung directly.

Robotic-assisted biopsy

Clinical trials show that a new type of robotic-assisted lung biopsy can get to hard-to-reach areas of the lung, and take a biopsy of very small tumours. This type of lung biopsy is only available in very few clinics.

Read about the new robotic test at the Royal Brompton.

After my lung biopsy

A nurse or other healthcare professional will check your blood pressure and oxygen levels. Ask for painkillers if you have any pain.

Your recovery time depends on the type of lung biopsy you had. If you had a needle lung biopsy, or a bronchoscopy biopsy, you may only need to wait for a few hours to make sure you feel well.

If you were sedated, you’ll need to wait until the sedation wears off.

If you had a general anaesthetic, someone needs to collect you from the hospital and take you home.

You may need to have a chest X-ray a few hours after the biopsy. If the results are normal, you can go home. If it shows possible complications, you may need to stay in hospital overnight.

If you had a surgical biopsy you may need to stay in hospital for a few days.

What are the risks of a lung biopsy? 

A lung biopsy is considered a safe test, with a low risk of complications.

Your healthcare professional will explain the possible risks of the procedure, such as:

• a collapsed lung (pneumothorax) – this happens when air leaks from your lung. Find out more about pneumothorax.
• coughing up blood – you may cough up a small amount of blood after the biopsy. This is usually not serious  but tell your healthcare professional if it continues.
• chest infections – contact your GP straight away if you have signs of a chest infection, like feeling more breathless, a temperature, or if your phlegm is not clear
• needing more oxygen at home – if you normally have oxygen therapy at home, you might need to have more than usual after your biopsy.

Chest drains

If you have a collapsed lung (pneumothorax) a small air leak can heal by itself in a few days. If it’s a bigger air leak, you may need a chest drain. This is where a small tube is put into the chest wall to remove air fluid or blood from the chest.

A chest drain may need to be in place for 24–48 hours. Sometimes you need a chest drain for longer if there is a lot of air or fluid. Healthcare professionals will make sure the drains are removed at the right time. They may need to do chest X-rays to check your lungs.

Some centres may send you home with a special type of drain so that you do not have to stay in hospital. 

You won’t get your biopsy results straight away. You may need to wait for 1 to 2 weeks. This gives the specialist doctor in charge of your care time to look at the results and work out what they mean. They’ll make an appointment for you to talk about the results and what happens next.

People with lung conditions sometimes tell us that it can feel worrying to get referred for a test like a biopsy. It may also be stressful to wait for your results after the test. It’s important to speak to someone you trust about how you’re feeling.

You can also find help and support through our:

• online communities on Health Unlocked – we have forums for people with asthma and other lung conditions to chat to each other, get support and share ideas
• support groups – we have many online and in-person support groups for people with lung conditions
• helpline – you can talk to our helpline about any aspect of your lung condition, or about how you’re feeling.

Find out more about looking after your mental health, including practical advice to improve your emotional wellbeing.