• Needle Biopsy of the Lung and Pleura

    (Transthoracic Needle Aspiration; Percutaneous Needle Aspiration)


    A needle biopsy of the lung or pleura is done to remove a sample of lung or pleural tissue, or fluid. Pleura is the lining of the lungs and chest wall. Once the tissue is removed, it will be examined in a lab.
    Female Torso with Respiratory System and Ribcage (Anterior View)
    BN00002 97870 1 labeled
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    This procedure is used to diagnose abnormal tissue in or around the lung. Possible reasons for abnormal tissue are:

    Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
    Factors that may increase the risk of complications include:
    Make sure to tell your doctor if you are pregnant.

    What to Expect

    Prior to Procedure

    Your doctor may order:
    • A complete physical exam
    • Blood tests
    • Images of the chest and lungs maybe taken with
    Leading up to your procedure, do not start taking any new medications without consulting your doctor.
    You may be given pre-procedure medications for certain conditions (eg, to suppress a cough).
    Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.


    • You may receive a mild sedative about an hour before the procedure. It will help you relax.
    • You may also have an injection of a local anesthetic. It will numb the area where the needle will be inserted.

    Description of the Procedure

    Your skin will be cleaned with an antiseptic solution. You will be in a seated position, leaning forward, with your arms resting on a table for support. You should remain as still as possible. An ultrasound or CT scan will be used to locate the exact area.
    A small cut will be made in your skin. Then, while you hold your breath, the biopsy needle will be inserted through the cut. The needle will be passed between your ribs until it reaches the lung or pleura. Your doctor then withdraws some cells through the biopsy needle. The needle will be withdrawn. Pressure will be put on the site of the incision. When the bleeding stops, a bandage will be applied.

    How Long Will It Take?

    30-60 minutes

    How Much Will It Hurt?

    • Before the procedure, when the local anesthetic is injected, you may feel a brief sting.
    • During the procedure, when the needle is inserted, you will probably feel some pressure. If you are having a lung biopsy, you will feel a quick, sharp pain when the needle touches your lung.

    Post-procedure Care

    At the Care Center
    • You will rest for several hours after the procedure. Your recovery will be monitored.
    • A few hours after the procedure, a chest x-ray or other imaging technique may be done. This is done to make sure a lung has not collapsed and that there is no bleeding.
    • If there are no complications after 4 hours, you may go home.
    At Home
    Rest for the first day or two. Your activity may be restricted for up to one week. Follow instructions on caring for the biopsy site to avoid infection.

    Call Your Doctor

    It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
    • Signs of infection, including fever and chills
    • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
    • Pain that you cannot control with the medications you've been given
    • Cough, shortness of breath, or chest pain
    • Coughing up blood
    • Pain when taking a deep breath
    • You feel your heart rate is fast
    If you think you have an emergency, call for medical help right away.


    American Cancer Society http://www.cancer.org

    American Lung Association http://www.lung.org


    Canadian Cancer Society http://www.cancer.ca

    The Lung Association http://www.lung.ca


    Light R, Lee G (eds). Textbook of Pleural Diseases. London, England: Arnold; 2003.

    Mason RJ. Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, PA: WB Saunders; 2005.

    Murray JF, Mason RJ. Murray & Nadel’s Textbook of Respiratory Medicine. 4th ed. Philadelphia, PA: Saunders, 2007.

    Ost D, et al. Clinical practice. The solitary pulmonary nodule. N Engl J Med. 2003;348:2535.

    Pleural biopsy. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test%5Fprocedures/pulmonary/pleural%5Fbiopsy%5F92,p07757. Accessed February 18, 2015.

    Transthoracic needle biopsy. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/pulmonary%5Fdisorders/diagnostic%5Fpulmonary%5Fprocedures/transthoracic%5Fneedle%5Fbiopsy.html. Updated September 2013. Accessed February 18, 2015.

    6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed : Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: A systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

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