Needle biopsy through the skin for lung cancer

This test is also called a percutaneous lung biopsy. A doctor called a radiologist takes a sample of lung tissue by passing a needle into the lung. They use a CT scanner or ultrasound to ensure they know the right place to take the sample.

You have this test with a local anaesthetic Open a glossary item. It takes about 30 to 45 minutes.

Diagram showing the lungs including the alveoli

Why do I need a biopsy through the skin?

You might have this test if your doctor has seen an abnormal looking area in your lung or airways using an x-ray or CT scan.

What do I need to do to prepare for a biopsy through the skin?

You’ll be given written instructions on how to prepare for your biopsy through the skin. For example, they will ask you not to eat and drink for a few hours before the test.

Take your usual medicines as normal unless your doctor tells you otherwise. If you take warfarin or other blood thinners to thin your blood, you need to stop this before your test. Your doctor will tell you when to stop them.

What happens on the day?

Before the test

When you arrive at the outpatient department the nurse takes some measurements. This includes your blood pressure, heart and breathing rate, your oxygen level and weight.

You’ll see your radiologist who will explain what’s going to happen and ask you to sign a consent form. This is a good time to ask any questions you may have.

You may need to change into a hospital gown, or you might be able to stay in your own clothes.

Having a local anaesthetic

The nurse takes you to the test room. You have the procedure on a couch, lying down in the best position for taking the biopsy.

The radiologist will clean your skin with antiseptic fluid and numb it with a local anaesthetic. The local anaesthetic used to numb the area may sting for a few seconds, but once this is working, you will not feel anything in that area.  

Attached to one of your fingers is a clip to monitor your heart rate and oxygen levels throughout the test.

During the test

A scan will be taken using a small metallic marker on the outside of your skin. This marker shows up in the scan images. It helps the radiologist decide the best place to take the biopsy.

The radiologist will ask you to hold your breath while they put a fine needle through your skin and into your lung to take the biopsy. You may feel some pressure from the biopsy needle as it takes the sample. The radiologist takes out some tissue through the needle and into a syringe. They may have to repeat this part of the test 2 to 3 times to take a good sample. 

They send the tissue to a laboratory. A pathologist then looks at the tissue down a microscope to see exactly what the abnormality is.

During the test, your nurse or anaesthetist will check your oxygen levels and heart rate using the clip on your finger.

The test takes about 30 to 45 minutes.

Diagram showing a percutaneous lung biopsy

After your biopsy

You might need to stay in hospital overnight. 

You go back to the ward so you can rest. You can eat and drink as usual.

Your nurse monitors you closely for a few hours. They check your heart rate and oxygen levels using a clip on your finger. This doesn’t hurt. They check your blood pressure regularly, using a cuff on your arm. Your nurse makes sure any pain you have is under control. Ask for painkillers if you need them.

You usually have a chest x-ray 3 or 4 hours after the biopsy.

Going home

You have a waterproof dressing over your biopsy site. Your nurse will tell you how to look after the dressing over the next few days.

You need to take things easy for a few days after the biopsy.

Possible risks

A biopsy through your skin is a very safe procedure. But your nurse will tell you who to contact if you have any problems after your test. Your doctors will make sure the benefits of having a biopsy outweigh these possible risks.

The possible risks include:

Bleeding

You might see a small amount of blood in your spit after the test. Let your doctor or nurse know if this doesn’t go away.

Chest infection

See your doctor straight away if your phlegm (sputum) changes colour, you feel more breathless or feel as though you have a temperature. Tell them if the dressing over the biopsy site has lots of ooze on it.

Needing extra oxygen

You might need oxygen through a mask for a while after the biopsy. If you normally have oxygen at home you might need to have more than usual for a time.

A collapsed lung (pneumothorax)

Air or gas can collect in the space around the lung and make it collapse, but this is rare. Contact a doctor if you become short of breath or have chest pain. You have a tube put into the lung to remove the air.

Let your doctor know if you are due to fly soon after your biopsy. They can give you advice about how long you should wait before taking a flight.

Getting your results

You should get your results within 1 or 2 weeks. Contact your doctor if you haven’t heard anything after this time.

Waiting for test results or for further tests can be very worrying. You might have contact details for a specialist nurse and you can contact them for information if you need to. It may help to talk to a close friend or relative about how you feel.

For support and information, you can also contact the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, from Monday to Friday.

More information

You can read more information about other tests to help doctors diagnose lung cancer.