This page was reviewed under our medical and editorial policy by
Sagun Shrestha, MD, Medical Oncologist and Hematologist
This page was updated on March 8, 2024.
A lung biopsy is a medical procedure where a doctor takes a tissue sample from the lungs to examine it under a microscope. It's performed in several different ways and used by medical professionals to look for cancer cells or other types of diseases.
The type of lung biopsy performed is determined by a patient’s doctor, and the exact biopsy procedure steps will vary depending on the type of biopsy performed. In general, there are four lung biopsy types:
Needle biopsy. Using a hollow needle, a doctor removes a small tissue sample without making an incision. If the area of tissue to sample is hard to reach, a computed tomography (CT) scan may be used to guide the biopsy needle to the appropriate location.
Transbronchial biopsy. A needle is guided through the airways that lead to the lungs, called the bronchi.
Thoracoscopic biopsy. A thoracoscope, a small tube with a camera on the end, is inserted into the body to take a tissue sample.
Open lung biopsy. Performed under general anesthesia, this type of biopsy involves making a small incision into the chest to remove a lung tissue sample.
Each type of lung biopsy is performed differently. Here’s a guide to help patients know what to expect for each:
During a needle biopsy, a long needle is inserted into the lung via the chest to take a tissue sample, often guided by a CT scan or ultrasound for accuracy. A needle biopsy is performed under local anesthetic, so the patient is awake but comfortable during the procedure.
The procedure should take about 30 to 45 minutes and is not painful, although patients may feel some pressure when the needle is inserted. In some instances, patients spend the night in the hospital, and all needle lung biopsy patients need to rest for a few days and follow aftercare instructions to keep their biopsy incision site clean.
A transbronchial lung biopsy is a type of needle biopsy performed in a similar way to a needle lung biopsy. However, a transbronchial biopsy enters the body via the bronchi, the large airways leading to the lungs. It’s performed during a bronchoscopy, a medical procedure that uses a bronchoscope, a long, flexible tube with a light and camera on the end, to look inside the lungs.
A transbronchial lung biopsy is an outpatient procedure and takes about 30 minutes. It’s sometimes performed using a numbing spray and other times under general anesthesia. Patients may be numb for a few hours after the procedure and notice hoarseness, a sore throat or cough for a few days.
A thoracoscopic lung biopsy is performed during a thoracoscopy, a procedure that uses a thoracoscope device—a long, thin tube with a camera and light—to look inside the body. This procedure may be performed as an outpatient surgery with local anesthesia or as a surgery under general anesthesia, which is more common when it’s performed as a video-assisted thoracic surgery (VATS).
A thoracoscopic lung biopsy may be used to biopsy:
During the procedure, which generally takes 30 to 90 minutes, a small incision is made near the shoulder blade and underarm area to insert the thoracoscope. Patients who have the procedure under general anesthesia may require hospitalization for a few days. Patients may also notice soreness or numbness for several days after the procedure.
If a sample of lung tissue needs to be removed via surgery, an open lung biopsy may be used, which is a surgical procedure performed under general anesthesia. A small incision is made in the chest, and the ribs will be gently separated so a tissue sample may be taken and tested. The incision is closed with stitches.
After the procedure, patients may remain on a breathing tube for a while. They may notice numbness or soreness for several days after the surgery.
While lung biopsies are generally safe and well tolerated, they pose a small possibility of risks. Potential complications for each type of lung biopsy may include those below.
Needle biopsy:
Additional oxygen may be required after the procedure.
Transbronchial biopsy:
Transbronchial biopsies carry an additional risk for older patients who have increased possibility of bleeding. While this is mild in most cases, patients should always speak with their doctor to learn more.
Thoracoscopic biopsy:
Some patients may require a more invasive procedure if this type of biopsy can’t be performed.
Open lung biopsy:
A doctor will explain in detail what side effects or risks may be a possibility for each person’s lung biopsy.
Biopsies are widely used medical procedures that allow doctors to determine if cancer is present. In very rare cases, instances of a biopsy moving a cancer cell to another part of the body, known as seeding, have occurred.
However, medical research shows that when a biopsy is performed to the highest possible standard, the risk of seeding is extremely low. Moreover, the benefits far outweigh the risks, as a biopsy is an important way to diagnose cancer and assist doctors in developing a treatment plan.
As with any procedure, patients should discuss the benefits and risks with their doctor.
On average, lung biopsies take two to 10 days for results to become available. If the results show cancerous cells, the doctor may order additional testing before beginning a treatment plan. Biopsies may also be done for genetic testing to assist with treatment decisions, as certain types of lung cancers may respond differently to treatments based on genetic mutations found in the body’s cells.