Pleural Biopsy

Overview :

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. Pleural biopsies are 85-90% accurate in diagnosing these diseases.

The procedure most often performed for pleural biopsy is called a percutaneous (passage through the skin by needle puncture) needle biopsy. The procedure takes 30-45 minutes, although the biopsy needle itself remains in the pleura for less than one minute. This type of biopsy is usually performed by a physician at bedside, if the patient is hospitalized, or in the doctor's office under local anesthetic.

The actual procedure begins with the patient in a sitting position, shoulders and arms elevated and supported. 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. Then the inner needle is removed and a trocar (an instrument for withdrawing fluid from a cavity) is inserted to obtain the actual biopsy specimen. As many as three separate specimens are taken from different sites during the procedure. These specimens are then placed into a fixative solution and sent to the laboratory for tissue (histologic) examination.