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The skin overlying the biopsy site is anesthetized and a small incision is made to allow insertion of the biopsy needle. This needle is inserted with a cannula (a plastic or metal tube) until fluid is removed.
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Who is not a candidate for pleural biopsy?
Because pleural biopsy is an invasive procedure, it is not recommended for patients with severe bleeding disorders.
When is a pleural biopsy needed?
Pleural biopsy is usually ordered when pleural fluid obtained by another procedure called thoracentesis (aspiration of pleural fluid) suggests infection, signs of cancer, or tuberculosis.
What is the most common form of pleural biopsy?
The procedure most often performed for pleural biopsy is called a percutaneous (passage through the skin by needle puncture) needle biopsy.
How many specimens are required for a pleural biopsy?
As many as three separate specimens are taken from different sites during the procedure.
What is the CPT code for pleural biopsy by percutaneous needle?
32400
What is the reason for a pleural biopsy?
Pleural biopsy is done to differentiate between benign and malignant disease, to diagnose viral, fungal, or parasitic diseases, and to identify a condition called collagen vascular disease of the pleura.
What is a normal reading for pleural biopsy?
Normal findings indicate no evidence of any pathologic or disease conditions.
What are some abnormal finding of pleural biopsy?
Abnormal findings include tumors, viral, fungal, or parasitic infections, and tuberculosis
What happens to the lungs during pleurisy?
Pleural effusion is excess fluid that accumulates between the two pleural layers, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during ventilation.
Pleural needle biopsy?
DefinitionA pleural biopsy is a procedure to remove a sample of the tissue lining the lungs and the inside of the chest wall to check for disease or infection.Alternative NamesClosed pleural biopsy; Needle biopsy of the pleuraHow the test is performedThis test does not have to be done in the hospital. It may be done at a clinic or doctor's office.You will be sitting up for the biopsy. The health care provider will cleanse the skin at the biopsy site, and inject a local numbing drug (anesthetic) through the skin and into the lining of the lungs and chest wall (pleural membrane).A larger, hollow needle is then placed through the skin and into the chest cavity. The doctor rotates the needle. At various times during the procedure, you will be asked to sing, hum, or say "eee." This helps prevent air from getting into the chest cavity, which can cause a lung collapse (pneumothorax).The doctor removes the needle to collect tissue samples. Usually, 3 biopsy samples are taken. When the test is completed, a bandage is placed over the biopsy site.How to prepare for the testYou will have blood tests before the biopsy, and you may have a chest x-ray taken. You must sign consent forms.How the test will feelWith the injection of the local anesthetic, you may feel a brief prick and a burning sensation. When the biopsy needle is inserted, you may feel pressure. As the needle is being removed, you may feel a tugging sensation.Why the test is performedPleural biopsy is usually done to determine the cause of a collection of fluid around the lung (persistent pleural effusion) or other abnormality of the pleural membrane. Pleural biopsy can diagnose tuberculosis, cancer, and other diseases.Normal ValuesThe pleural tissues appear normal, without signs of inflammation, infection, or cancer.Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.What abnormal results meanAbnormal results may reveal cancer, tuberculosis, a viral disease, a fungal disease, a parasitic disease, or collagen vascular disease.Other conditions under which the test may be done include:Malignant mesotheliomaMetastatic pleural tumorPrimary lung cancerWhat the risks areThere is a slight chance of the needle puncturing the wall of the lung, which can partially collapse the lung. This usually gets better on its own. There is a chance of excessive blood loss.Special considerationsIf a closed pleural biopsy is not enough to make a diagnosis, you may need a surgical biopsy of the pleura.ReferencesBroaddus VC, Light RW. Pleural Effusion. In: Mason RJ, Murray J, Broaddus VC, Nadel JA. Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: WB Saunders; 2005: chap 68.Ernst A, Silvestri GA, Johnstone D. Interventional Pulmonary Procedures: Guidelines from the American College of Chest Physicians. Chest. May 2003: Vol. 123; pp. 1693-1717.
Pleural cavity pressure?
Pleural pressure, or Ppl, is the pressure surrounding the lung, within the pleural space. During quiet breathing, the pleural pressure is negative; that is, it is below atmospheric pressure.
What are some risks associated with pleural biopsy?
Potential complications of this procedure include bleeding or injury to the lung, or a condition called pneumothorax, in which air enters the pleural cavity (the space between the two layers of pleura lining the lungs and the chest wall).
