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Open pleural biopsy

Definition

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.

Alternative Names

Biopsy - open 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.

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 afterwards.

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.

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. Philadelphia, PA: Elsevier; 2013:199-202.

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


Review Date: 11/11/2016
Reviewed By: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana. 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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