肺穿刺活检

定义

A lung needle biopsy is a method to remove a piece of lung tissue for examination. If it is done through the wall of your chest, it is called a transthoracic lung biopsy.

选择的名字

Transthoracic needle aspiration; Percutaneous needle aspiration

如何执行测试

The procedure usually takes 30 to 60 minutes. The biopsy is done in the following way:

• A 胸部x光片 or 胸部CT扫描 may be used to find the exact spot for the biopsy. If the biopsy is done using a CT scan, you may be lying down during the exam.
• You may be given a sedative to relax you.
• You sit with your arms resting forward on a table. Your skin where the biopsy needle is inserted is scrubbed.
• A local painkilling medicine (anesthetic) is injected.
• The doctor makes a small cut in your skin.
• The biopsy needle is inserted into the abnormal tissue, 肿瘤或肺组织. A small piece of tissue is removed with the needle.
• 针头被取出. 在现场施加压力. Once bleeding has stopped, a bandage is applied.
• A 胸部x光片 is taken right after the biopsy.
• The biopsy sample is sent to the lab. 分析通常需要几天的时间.

如何准备考试

You should not eat for 6 to 12 hours before the test. Follow instructions about not taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, 布洛芬, or blood thinners such as warfarin for a period of time before the procedure. Check with your health care provider before changing or stopping any medicines.

Before a needle biopsy 肺的, a 胸部x光片 or 胸部CT扫描 may be performed.

考试的感觉如何

You will receive an injection of anesthetic before the biopsy. This injection will sting for a moment. You will feel pressure and a brief, sharp pain when the biopsy needle touches the lung.

为什么要进行测试

A lung needle biopsy is done when there is an abnormal condition near the surface 肺的, 在肺本身, 或者胸壁. Most often, it is done to check for cancer. The biopsy is usually done after abnormalities appear on a 胸部x光片 or CT scan. Sometimes your doctor might recommend a bronchoscopy instead of lung needle biopsy depending on the location of the abnormality.

正常的结果

在常规测试中, the tissues are normal and there is no cancer or growth of bacteria, 病毒, or fungi if a culture is performed.

异常结果意味着什么

An abnormal result may be due to any of the following:

• Bacterial, viral, or fungal lung infection
• 癌细胞(肺癌, 间皮瘤)
• 肺炎
• 良性的发展

风险

有时，肺萎陷(气胸)在此测试之后发生. A 胸部x光片 will be done to check for this. The risk is higher if you have certain lung diseases such as 肺气肿. Usually, a collapsed lung after a biopsy does not need treatment. 但如果气胸很大, there is preexisting lung disease or it does not improve, a chest tube is inserted to expand your lung.

在极少数情况下, 气胸 can be life threatening if air escapes from the lung, 被困在胸部, and presses on the rest of your lungs or heart.

Whenever a biopsy is done, there is a risk of too much bleeding (hemorrhage). Some bleeding is common, and a provider will monitor the amount of bleeding. 在极少数情况下, major and life-threatening bleeding can occur.

A needle biopsy should not be performed if other tests show that you have:

• 任何类型的出血性疾病
• Bullae (enlarged alveoli that occur with 肺气肿)
• 肺心病 (condition that causes the right side of the heart to fail)
• 囊肿 肺的
• High blood pressure in the lung arteries
• 严重的 缺氧 (低氧)

注意事项

Signs of a collapsed lung include:

• 皮肤发蓝
• 胸部疼痛
• 心率加快 (快速脉冲)
• 呼吸急促（气促）

If any of these occur, call your provider right away.

参考文献

Given MF, Clements W, Thomson KR, Lyon SM. Percutaneous biopsy and drainage 肺的, mediastinum, and pleura. In: Mauro MA, Murphy KPJ, Thomson KR, Venbrux AC, Morgan RA, eds. 图像引导的干预措施. 3日艾德. Philadelphia, PA: Elsevier; 2021:chap 103.

沃尔什R，克莱因JS. Thoracic radiology: invasive diagnostic imaging and image-guided interventions. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7日艾德. Philadelphia, PA: Elsevier; 2022:chap 21.