Lung Biopsy in Radiology

Your primary doctor has scheduled a lung biopsy to be done in CT on _________________  at.  Please report to the G3/3 Radiology desk (Atrium elevators to the 3rd floor) a few minutes before__________________..

 

Before the biopsy our doctors will explain the procedure further and ask your consent to do it.  This handout tells you what you need to know before you come in.  Phone numbers to answer any questions are on the last page.

 

How to Prepare for the Biopsy

 

• You will need to have blood work done before your biopsy to test blood clotting.  This can be done the morning of the biopsy in the outpatient lab.  You must you come in 30 minutes before your check-in time.  If you have your blood work done elsewhere, bring the results with you the day of your biopsy or have them faxed to 608-265-8637, attention CT biopsy RN.  The blood work is a platelet count and INR.  Results must be less than 6 months old, if normal. 

 

• If you are currently taking aspirin, ibuprofen, warfarin, Plavix® or Coumadin® daily, we will discuss this with your doctor and either we or your doctor’s office will call you.  You will either
  • be given other therapy by your doctor.
  • allowed to stop the medicine for one week before the biopsy.
  • asked to continue low dose aspirin through the day of the biopsy.
    

 

• Take no ibuprofen or naproxen for 7 days before your biopsy.

 

• 4. Let us know if you have developed any new allergies or if you are pregnant.

 

• Please plan to have someone drive you home.  We strongly suggest you have someone stay the night with you.  develop and you need medical care right away help is nearby.

 

• Stop eating 6 hours (__________) before the procedure.  You may drink clear liquids up until 2 hours (__________) before the procedure.  (Black coffee, fruit juice with no pulp, water.)

 

• If you have diabetes:  Do not take any regular insulin (Novolog/aspart, Humalog/lispro, Apidra/glulisine).  Take ½ dose NPH is you normally take it in the morning.  Take your usual dose if you take Glargine/Lantus or Detemir/levemir.  Your blood sugar will be checked in the prep area.

 

• Take your scheduled prescribed oral medicines, except diuretics/water pills, as usual with a small sip of water.

 

During the Biopsy

 

An intravenous (IV) catheter will be started to give you fluids.  Medicine to relax you is often given through the IV during the procedure.

 

Once in the CT scanner, the first scans will be taken to check position and for any changes in the nodule.  The radiologists will mark the area on your chest.  They will clean the skin with a disinfectant soap.  The site will be numbed with lidocaine.  Normally, our patients do not feel very much pain during this procedure, but you may feel pressure during the tissue removal.

 

The tissue sample is taken using a special needle that is placed through the skin into the lung. 

 

Several samples may be taken during the procedure and handed to a cytopathologist.  The doctors wait for the cytopathologist to tell them if they have enough cells for an accurate exam before ending the procedure.  If a core tissue sample is taken it is placed in fluid  and hand carried to the Pathology Lab to be checked under microscopes for any disease

 

After the Biopsy

 

After the biopsy, a Band-Aid® will be applied to the site where the tissue sample was taken.

 

You will be taken back to the prep area, where you will be on bed rest for one hour. You will not be allowed to eat or drink until after the 1st chest x-ray is taken.  This x-ray makes sure that your lung is still expanded.  After the x-ray is checked by the doctor and cleared, you may be allowed to eat and drink whatever you would like.  You can move around your room and go to the bathroom.

If the x-ray shows you have an accumulation of air around your lung, you will not be allowed to eat.  You will need a 2nd x-ray 2 hours after the 1st.  You could be in the prep area up to 4 hours before you are allowed to go home. 

 

If the accumulation of air increases or you have symptoms of shortness of breath or changes in your vital signs, you may have a small tube inserted in your lung to re-expand it.  If such a tube is needed, you will be admitted to the hospital overnight.

 

After the local anesthetic wears off, you may feel “somewhat sore” at the biopsy site.  No medicines are prescribed after the biopsy.  If you are having discomfort at the site, we suggest the use of Tylenol® or Motrin®.  The soreness should be mostly gone after 24 hours.

 

Your Care at Home after the Biopsy

 

• You may return to your normal diet.  Do not drink alcoholic beverages for 24 hours.
• No smoking for 24-hours.  If you cough, try to cough as gently as possible.
• Rest and do not do any strenuous activities, such as heavy lifting or activities that raise your heart rate a lot.  Resume your normal routine after 24 hours, but do not do strenuous activity for 5-7 days.  Airplane travel is not recommended for 2-3 weeks after the procedure.
• You may remove the Band-Aid® and shower the next morning. 
• You may have flecks of blood in your sputum when you cough or blow your nose, for 1-3 days. This is normal.

 

When to Call the Doctor

 

Important!  If you have shortness of breath, or can’t get your breath, you need to go to the nearest emergency room right away.  Don’t wait to see if it gets better.

 

Listed below are other reasons to call your doctor.

 

• If you have lots of bleeding at the biopsy site.
• If your pain around the biopsy site gets worse rather than better 2-3 days after the biopsy.
• If you have a large increase in sputum within the first 24 hours after the procedure.
• If your sputum production includes clots bigger than a fifty cent piece.
• If you have a fever greater than 101° F.  If you are not feeling well, check your temperature by mouth.

 

If you have any questions or problems once you are at home, call

608-263-0693 Monday through Friday, 8:00 a.m. to 4:30 p.m. to speak to the biopsy nurse.  If you cannot reach the nurse in a timely manner, call one of the numbers below for the radiologist on call.

 

Evenings and weekends call the paging operator, 608-262-0486.  Ask for the radiologist on call.  Tell them which doctor performed your procedure.  Leave your name and phone number with the area code. The doctor will call you back.

 

If you live out of the area please call 1-800-323-8942 and ask them to connect you.

 

You should receive results within 1-3 days.  If you have not heard from your primary doctor within that time, please call that doctor for the results.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 09/02/2011

Copyright © 09/02/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6562

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