32405 Biopsy, lung or mediastinum, percutaneous needle

Name of the Procedure:

Biopsy, lung or mediastinum, percutaneous needle

Summary

A percutaneous needle biopsy of the lung or mediastinum is a minimally invasive procedure where a thin needle is inserted through the skin to obtain a tissue sample from the lung or mediastinum (the central part of the chest cavity). This sample is then analyzed to help diagnose various conditions.

Purpose

The procedure is typically performed to diagnose abnormalities such as tumors, infections, or other lung diseases. The goals are to obtain a tissue sample that can provide definitive information to guide further treatment or management, and to do so with minimal risk and discomfort.

Indications

• Persistent or unexplained lung masses or nodules seen on imaging
• Symptoms such as chronic cough, unexplained weight loss, or chest pain
• Suspicion of infections or inflammatory conditions not diagnosed through other means
• Monitoring of known lung conditions

Preparation

• Patients may be asked to fast for a few hours before the procedure.
• Blood tests, chest X-rays, or other imaging studies might be needed.
• Medication adjustments, especially blood thinners, might be required.
• Discuss allergies and current medications with the healthcare provider.

Procedure Description

1. The patient lies on a table in a position that allows the best access to the biopsy site.
2. The skin over the biopsy area is cleaned and sterilized.
3. Local anesthesia is administered to numb the area.
4. Using imaging guidance, typically a CT scan or ultrasound, the radiologist inserts a thin needle through the skin into the targeted area of the lung or mediastinum.
5. A tissue sample is collected through the needle.
6. The needle is carefully removed, and pressure is applied to stop any bleeding.
7. The sample is sent to a laboratory for analysis.

Tools: Thin biopsy needle, imaging technology like CT scan or ultrasound. Anesthesia: Local anesthesia is commonly used; sedation is rare but may be considered.

Duration

The entire procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital radiology department or specialized outpatient clinic.

Personnel

• Radiologist or pulmonologist specialized in performing biopsies
• Radiology technician
• Nursing staff for patient care and monitoring

Risks and Complications

Common risks:

• Pain or discomfort at the biopsy site
• Minor bleeding or bruising

Rare risks:

• Infection at the biopsy site
• Collapsed lung (pneumothorax)
• Severe bleeding

Complications are usually managed with medications or additional procedures if necessary.

Benefits

• Provides a definitive diagnosis for appropriate treatment planning.
• Minimally invasive compared to surgical biopsy.
• Short recovery time.

Recovery

• Patients are observed for a few hours to ensure there are no immediate complications.
• Avoid strenuous activities for at least 24-48 hours.
• Follow-up appointments to discuss biopsy results and further treatment.

Alternatives

• Surgical biopsy: more invasive but may be needed if percutaneous biopsy is not feasible.
• Bronchoscopy with biopsy: another less invasive method, but may not reach certain areas.
• Imaging studies and monitoring: non-invasive but may not provide definitive diagnosis.

Pros and cons should be discussed with the healthcare provider based on the patient’s specific condition.

Patient Experience

During the procedure, patients may feel slight pressure but should not experience significant pain due to the local anesthesia. Post-procedure soreness is possible but generally mild. Pain management options will be provided to ensure comfort.