Name of the Procedure:

Biopsy, pleura, percutaneous needle

• Common Name(s): Pleural biopsy, Needle biopsy of the pleura
• Medical Term: Percutaneous needle pleural biopsy

Summary

A pleural biopsy using a needle involves removing a small sample of the pleura (the membrane surrounding the lungs) using a needle. This procedure helps diagnose conditions affecting the pleura.

Purpose

• Medical Condition/Problem: This procedure addresses unexplained pleural effusion (fluid accumulation between the pleura), potential infections, and possible malignant diseases of the pleura.
• Goals/Outcomes: The primary goal is to obtain a tissue sample for microscopic examination to diagnose or rule out conditions such as infections, tuberculosis, cancer, or inflammatory diseases.

Indications

• Symptoms/Conditions: Persistent unexplained pleural effusion, chronic cough, chest pain, unexplained weight loss.
• Patient Criteria: Patients with abnormal imaging findings involving the pleura, inconclusive thoracentesis results, or when pleural malignancy or infection is suspected.

Preparation

• Pre-procedure Instructions: Patients may need to fast for a few hours before the procedure. It's important to adjust or stop certain medications, especially blood thinners, under medical advice.
• Diagnostic Tests: Chest X-ray, CT scan, or ultrasound to guide the needle placement. Blood tests to check clotting function.

Procedure Description

1. Patient Positioning: The patient is usually seated or in a slightly reclined position.
2. Local Anesthesia: The procedure area is numbed with local anesthesia to minimize pain.
3. Needle Insertion: Using imaging guidance, a thin needle is inserted through the chest wall into the pleura.
4. Sample Collection: A small pleural tissue sample is collected through the needle.
5. Needle Removal: The needle is carefully withdrawn, and a small bandage is applied.

• Equipment: Fine needle, local anesthetic, imaging equipment (ultrasound, CT scan).
• Sedation: Typically local anesthesia, sedation may be used based on patient needs.

Duration

The procedure usually takes about 30 to 60 minutes.

Setting

Performed in a hospital, specifically in an outpatient clinic or a radiology department.

Personnel

Involves healthcare professionals such as:

• Interventional radiologist or pulmonologist
• Nurses
• Radiologic technologist

Risks and Complications

• Common Risks: Pain at the biopsy site, minor bleeding, and mild infection.
• Rare Complications: Pneumothorax (collapsed lung), significant bleeding, or severe infection.

Benefits

• Expected Benefits: Accurate diagnosis of pleural conditions, enabling appropriate treatment.
• Timeframe: Pathology results typically available within a few days to a week.

Recovery

• Post-procedure Care: Monitoring for a few hours, pain management, and instructions for bandage care.
• Expected Recovery Time: Most patients can resume normal activities within a day or two. Follow-up appointments may be needed to discuss results and next steps.

Alternatives

• Other Treatments: Thoracentesis (fluid removal), surgical biopsy.
• Pros and Cons: Thoracentesis is less invasive but may not provide enough tissue for a conclusive diagnosis. A surgical biopsy offers a larger sample but involves more risk and longer recovery.

Patient Experience

• During Procedure: Some discomfort or pressure sensation; the local anesthesia helps reduce pain.
• After Procedure: Minor soreness at the biopsy site; manageable with over-the-counter pain relief.
• Pain Management: Local anesthetics during procedure, pain relievers, and rest after the biopsy.