What is a pleural biopsy?
A biopsy is a procedure done to remove a tissue sample from the body so it can be
examined. The pleura is a double layer of membranes that surrounds the lungs. A pleural
biopsy is a procedure to remove a small piece of the pleura. This is done with a special
biopsy needle. Or it’s done during surgery. The biopsy is done to look for infection,
cancer, or another condition.
There are 3 types of pleural biopsy:
Needle biopsy. The healthcare provider puts a numbing medicine (local anesthetic) on the chest.
They put a special needle into the pleural membrane to take out a sample. Imaging
such as an ultrasound (high-frequency sound waves) or a CT scan (a series of X-rays
and a computer) may be used to guide the biopsy needle into the right place.
Thoracoscopic biopsy. The healthcare provider numbs the skin of the chest and gives sedating medicines
to make you sleepy. Sometimes, general anesthesia is used. A flexible, lighted tube
(endoscope) is put into the pleural space. This is the space between the two layers
of pleura. The endoscope lets the healthcare provider see the pleura and take a piece
Open biopsy. This is done under general anesthesia. This method is used by the healthcare provider
if the sample from the needle biopsy is too small to get a diagnosis. The provider
will make a cut (incision) in the skin to access the lung. They then remove a piece
of the pleura.
Why might I need a pleural biopsy?
A pleural biopsy may be done to:
Check an abnormal spot of the pleura seen on a chest X-ray or other imaging test
Find the cause of a pleural infection or other condition
Look for the cause of excess fluid in the pleural space (pleural effusion)
Find out if a pleural tumor is cancer (malignant) or not cancer (benign)
Get more information after a pleural fluid test shows there may be cancer, tuberculosis
(TB), or another infection
Your healthcare provider may also have other reasons to advise a pleural biopsy.
What are the risks of a pleural biopsy?
All procedures have some risks. The risks of this procedure may include:
Your risks may vary depending on your general health and other factors. Ask your healthcare
provider which risks apply most to you. Talk with them about any concerns you have.
Pleural biopsy shouldn’t be done in people with certain bleeding conditions.
How do I get ready for a pleural biopsy?
Your healthcare provider will explain the procedure to you. Ask any questions you
have. Your provider may ask you to sign a consent form that gives permission to do
the procedure. Read the form carefully. Before you sign the form, ask questions if
anything is not clear.
Tell your healthcare provider if you:
Are pregnant or think you may be pregnant
Are sensitive to or allergic to any medicines, latex, tape, or anesthetic medicines
(local and general)
Take any medicines, including prescriptions, over-the-counter medicines, vitamins,
and herbal supplements
Have had a bleeding disorder
Take blood-thinning medicine (anticoagulant), aspirin, or other medicines that affect
Stop taking certain medicines before the procedure, if instructed by your healthcare
Plan to have someone drive you home from the hospital.
Follow any other instructions your healthcare provider gives you.
You may have imaging tests before the procedure. These are done to find the right
spot to do the biopsy. You may have any of the below:
What happens during a pleural biopsy?
You may have your procedure as an outpatient. This means you go home the same day.
Or it may be done as part of a longer stay in the hospital. The way the procedure
is done may vary. It depends on your condition and your healthcare provider's methods.
In most cases, a needle biopsy will follow this process:
Your healthcare provider may ask you to remove your clothes. If so, you will be given
a hospital gown to wear. They may ask you to remove jewelry or other objects.
Your healthcare provider may give you oxygen through a nasal tube or face mask. They
will watch your heart rate, blood pressure, and breathing during the procedure.
For a needle biopsy, you may be in a sitting position in a hospital bed. Your arms
will be resting on an over-bed table. This position helps to spread out the spaces
between the ribs, which is where the needle is inserted. If you are not able to sit,
you may lie on your side on the edge of the bed.
Your healthcare provider will clean the skin where the needle will be put in with
an antiseptic solution.
Your healthcare provider will inject a numbing medicine (local anesthetic) in the
When the area is numb, the healthcare provider will put a needle between the ribs
in your back. You may feel some pressure where the needle goes in. One or more samples
of pleural tissue will be removed.
Your healthcare provider may ask you to hold still, exhale deeply, or hold your breath
at certain times during the procedure.
The biopsy needle will be removed. Your healthcare provider will apply firm pressure
to the site until any bleeding has stopped. A bandage or dressing will be put on the
The tissue samples will be sent to a lab.
You may have a chest X-ray taken right after the biopsy.
What happens after a pleural biopsy?
After the procedure, your healthcare provider will watch your blood pressure, pulse,
and breathing. You may have another chest X-ray done a few hours after the procedure.
Your provider will check the dressing over the puncture site for bleeding or other
If you had an outpatient procedure, you will go home when your healthcare provider
says it’s OK. Someone may need to drive you home.
At home, you can go back to your normal diet and activities, if instructed by your
healthcare provider. You may be told not to do strenuous physical activity for a few
The biopsy site may be tender or sore for several days. You can take pain medicine
as advised by your healthcare provider. Aspirin and certain other pain medicines may
increase bleeding. Make sure to take only the medicines your healthcare provider advises.
Call your healthcare provider if you have any of the below:
Fever of 100.4°F (38°C) or higher, or as advised by your healthcare provider
Redness or swelling of the needle site
Blood or other fluid leaking from the needle site
Feeling short of breath
Coughing up blood
Your healthcare provider may give you other instructions after the procedure.
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how will you get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure