Name of the Procedure:

Core Needle Biopsy, Lung or Mediastinum, Percutaneous, including Imaging Guidance

Summary

A core needle biopsy of the lung or mediastinum is a procedure where a needle is inserted through the skin to collect a small tissue sample from a suspicious area in the lung or the mediastinal region (the area between the lungs). This procedure is typically performed with the help of imaging techniques like CT scans or ultrasound to guide the needle accurately to the target area.

Purpose

This procedure is used to diagnose abnormal areas or masses found in the lungs or mediastinum. It helps to determine whether these areas are cancerous, infectious, inflammatory, or benign. The goal is to obtain enough tissue to allow for an accurate diagnosis and appropriate treatment planning.

Indications

• Detection of suspicious lung nodules or masses on imaging studies.
• Enlargement of lymph nodes in the mediastinum.
• Evaluation of recurrent or persistent lung infections.
• Assessment of known lung or mediastinal masses to gather more information about their nature.

Preparation

• Patients may be instructed to fast for a few hours before the procedure.
• Certain medications, like blood thinners, may need to be temporarily stopped.
• Blood tests to check for clotting function.
• Imaging studies such as chest X-rays, CT scans, or MRIs for procedural planning.

Procedure Description

1. The patient will lie on a table, typically in a CT scanner or ultrasound room.
2. Local anesthesia will be administered to numb the area where the biopsy needle will be inserted.
3. Using imaging guidance, the physician will insert the core needle through the skin and maneuver it to the suspicious area in the lung or mediastinum.
4. Multiple samples may be taken to ensure adequate tissue is obtained.
5. The needle is removed, and a small bandage is applied to the insertion site.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

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

Personnel

• Interventional radiologist or pulmonologist.
• Radiology technician.
• Nursing staff.
• Sometimes an anesthesiologist if sedation is required.

Risks and Complications

• Minor bleeding at the biopsy site.
• Pneumothorax (collapsed lung), which may require a chest tube.
• Infection at the site of needle insertion.
• Inadequate sample, requiring a repeat biopsy.
• Rare but serious complications like significant bleeding.

Benefits

• Provides a definitive diagnosis for suspicious lung or mediastinal lesions.
• Minimally invasive compared to surgical biopsy.
• Aids in accurate treatment planning and prognosis.

Recovery

• Patients may be observed for a few hours to monitor for complications like pneumothorax.
• Instructions on how to monitor the biopsy site for signs of infection or excessive bleeding.
• Avoid strenuous activity for at least 24 hours.
• Follow-up appointment for discussing biopsy results and further treatment.

Alternatives

• Surgical biopsy (more invasive, higher risk).
• Watchful waiting with repeat imaging (depending on the situation).

• Non-invasive imaging tests (may not provide definitive diagnosis).

  Patient Experience

  Patients might feel a slight pinch or pressure during anesthetic administration and needle insertion. Post-procedure, there might be some soreness at the biopsy site. Pain management will be provided if necessary, and comfort measures include rest and monitoring for any adverse symptoms.