Having a pleural biopsy

During a biopsy, a small piece of tissue is removed so that it can be looked at under a microscope. For a pleural biopsy, doctors usually take a piece of tissue from the pleura. The pleura is the lining that covers the lungs. Once the doctor has taken the biopsy, they will send it to the laboratory. A doctor who specialises in examining cells (pathologist) will look at the biopsy.

Having a biopsy can be uncomfortable but should not be painful. If you have any pain during or after the procedure, let your doctor or nurse know.

We describe some of the ways your doctor may take a pleural biopsy below.

See also

CT or ultrasound guided pleural biopsy

The doctor will give you a local anaesthetic to numb the area. They will use an ultrasound or CT scan to help guide them to the right place. Then, they will pass a special type of needle through your skin into the thickened area. The needle has a tip that can cut out a sample of tissue.

Thoracoscopy guided pleural biopsy

A thoracoscopy lets the doctor look at the pleura and the area around the lungs. If needed, the doctor can also take biopsies.

Talc pleurodesis

If your doctor drains off fluid from the pleural cavity (the space between the two layers of the pleura) during any tests, they may also do a procedure to try and stop the fluid coming back. This is called a talc pleurodesis. After the fluid is drained, they will put sterile talcum powder through the tube in your chest and into the pleural space. This helps stick the two linings together, to help stop the fluid from building up again.

EBUS and mediastinoscopy

Your doctor may need to take a sample from the lymph nodes in the middle of the chest (mediastinum). Doctors may be able to reach these from your windpipe using a flexible camera. This is called an endobronchial ultrasound (EBUS).

For larger biopsies, doctors may need to do a mediastinoscopy under general anaesthetic.