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Open pleural biopsy

Biopsy - open pleura

An open pleural biopsy is a procedure to remove and examine the tissue that lines the inside of the chest. This tissue is called the pleura.

How the Test is Performed

An open pleural biopsy is done in the hospital using general anesthesia. This means you will be asleep and pain free. A tube will be placed through your mouth down your throat to help you breathe.

The surgery is done in the following way:

  • After cleaning the skin, the surgeon makes a small cut in the left or right side of the chest.
  • The ribs are gently separated.
  • A scope may be inserted to see the area to be biopsied.
  • Tissue is taken from inside the chest and sent to a laboratory for examination.
  • After surgery, the wound is closed with stitches.
  • Your surgeon may decide to leave a small plastic tube in your chest to prevent air and fluid from building up.

The breathing tube may not be able to be removed right after surgery. So, you may need to be on a breathing machine for some time.

How to Prepare for the Test

You should tell the health care provider if you are pregnant, allergic to any medicines, or if you have a bleeding problem. Be sure to tell your provider about all the medicines you take, including herbs, supplements, and those bought without a prescription.

Follow your surgeon's instructions for not eating or drinking before the procedure.

How the Test will Feel

When you wake up after the procedure, you will feel drowsy for several hours.

There will be some tenderness and pain where the surgical cut is located. Most surgeons inject a long-acting local anesthetic at the surgical cut site so that you will have very little pain afterward.

You may have a sore throat from the breathing tube. You can ease the pain by eating ice chips.

You may have a tube in your chest to remove air. This will be removed later.

Why the Test is Performed

This procedure is used when the surgeon needs a larger piece of tissue than can be removed with a pleural needle biopsy. The test is most often done to rule out mesothelioma, a type of lung tumor.

It is also done when there is fluid in the chest cavity, or when a direct view of the pleura and the lungs is needed.

This procedure may also be done to examine a metastatic pleural tumor. This is a type of cancer that has spread from another organ to the pleura.

Normal Results

The pleura will be normal.

What Abnormal Results Mean

Abnormal findings may be due to:

Risks

There is a slight chance of:

  • Air leak
  • Excess blood loss
  • Infection
  • Injury to the lung
  • Pneumothorax (collapsed lung)

References

Chernecky CC, Berger BJ. Biopsy, site-specific - specimen. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:199-202.

Putnam JB. Lung, chest wall, pleura, and mediastinum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 57.

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  • Lungs - illustration

    The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

    Lungs

    illustration

  • Incision for pleural tissue biopsy - illustration

    In an open pleural biopsy, a small piece of the pleural tissue is removed through a surgical incision in the chest. After the sample is obtained, a chest tube is placed and the incision is closed with stitches. Abnormal results may indicate tuberculosis, abnormal growths, viral, fungal, and parasitic diseases.

    Incision for pleural tissue biopsy

    illustration

  • Pleural cavity - illustration

    The pleural cavity is composed of the layers of the membrane lining the lung and the chest cavity.

    Pleural cavity

    illustration

  • Lungs - illustration

    The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

    Lungs

    illustration

  • Incision for pleural tissue biopsy - illustration

    In an open pleural biopsy, a small piece of the pleural tissue is removed through a surgical incision in the chest. After the sample is obtained, a chest tube is placed and the incision is closed with stitches. Abnormal results may indicate tuberculosis, abnormal growths, viral, fungal, and parasitic diseases.

    Incision for pleural tissue biopsy

    illustration

  • Pleural cavity - illustration

    The pleural cavity is composed of the layers of the membrane lining the lung and the chest cavity.

    Pleural cavity

    illustration

Tests for Open pleural biopsy

 
 

Review Date: 10/23/2018

Reviewed By: Mary C. Mancini, MD, PhD, Director, Cardiothoracic Surgery, Christus Highland Medical Center, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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