Pleural Biopsy

Constant chest pain, shortness of breath or pleural effusion may be concerning to patients and their families. Scans and simple tests are sufficient to make a diagnosis in most instances.  However, there are cases in which these tests cannot clearly explain the origin of pleural disease. Here, doctors may recommend a pleural biopsy.

A pleural biopsy helps the doctor understand conditions related to the pleura, the thin surface surrounding the lungs. At Gleneagles Hospitals, pleural biopsy is recommended when necessary, with the patient's safety, comfort, and diagnostic clarity taken into consideration.

A pleural biopsy is a medical procedure in which a small piece of tissue is removed from the pleura for laboratory examination. The pleura consists of two layers, with one covering the lungs and the other covering the chest wall. Conditions of this lining may cause the accumulation of fluid, thickening, or pain without an apparent cause.

A pleural biopsy yields a tissue sample that is viewed under a microscope. This will assist the doctors in identifying infections, inflammation, or conditions such as cancer that are not detected by scans alone.

Pleural biopsy is a diagnostic test and does not provide treatment by itself. It is intended to assist physicians in determining the best course of action.

A pleural biopsy is recommended when the doctors require more definitive clues about the conditions surrounding the lung lining. It assists in making a proper diagnosis and subsequent treatment.

• To either rule out or confirm the presence of cancers in the lungs or pleura, including secondary spread of other organs.
• To determine any infections, such as tuberculosis or some fungal infections.
• To evaluate inflammatory or immune-related pleural disorders.
• To establish the aetiology of unexplained fluid around the lungs in cases of inconclusive fluid tests.
• To look at abnormal pleural thickening or growths on imaging scans.

By understanding the underlying problem, doctors can tailor treatment to the patient’s specific condition.

A biopsy is not necessary in all patients with pleural problems. The choice is determined after examining symptoms, scan images, and the results of prior tests.

Patients who may be considered suitable include:

• Patients with persistent or unexplained pleural effusion.

• Patients whose pleural fluid tests have failed to diagnose them.
• Pleural thickening or nodules on imaging.
• Patients for whom a precise diagnosis must be identified before starting treatment.

Even when doctors at Gleneagles Hospitals prescribe a biopsy, they ensure that the advantages of the procedure outweigh the risks.

A pleural biopsy can be performed in several ways. The approach is based on the patient's status, scan results, and overall health.

• Needle pleural biopsy: A small needle is inserted into the chest wall, and a piece of tissue is collected.
• Thoracoscopic biopsy: A special endoscope is inserted into the pleural cavity under local or general anaesthesia. Any suspicious tissue can be examined, and its pleural surface can be visualised with the endoscope.
• Open biopsy: The procedure is performed under general anaesthesia with a method involving an incision of the skin and excision of part of the pleura.

The pleural biopsy at Gleneagles Hospital is conducted in a controlled, clinical setting under the supervision of experienced experts.

Before the Procedure

Prior to the biopsy, routine patient checks, such as blood tests and imaging, are performed. Past medical history and present medications are scrutinised.

Patients are usually advised to:

• Eat and drink a few hours before the procedure.
• Report to the physician concerning anti-coagulant drugs.
• Arrange for someone to accompany them, if required.

The process is described in detail to inform patients.

During the Procedure

Local anaesthesia is applied to desensitise the area, and sedation can be administered if required. To collect tissue, the doctor uses a small hole in the chest wall to insert the needle or scope.

Patients may experience pressure or mild discomfort, although severe pain is rare. The procedure is monitored by evaluating vital signs. Depending on the operation technique, it takes a certain amount of time.

After the Pleural Biopsy

Patients are monitored after the biopsy to help exclude any immediate complications.

Common experiences after the procedure include:

• Mild or moderate discomfort at the biopsy site.
• Short-term breathing difficulty.
• Exhaustion until the end of the day.

Most patients can return home the same day, unless extended observation is needed. A sample of tissue is sent to the lab. Results may be available in a few days, depending on the tests that need to be performed.

When the procedure is performed on the right patients, pleural biopsy is generally safe. However, some risks may occur.

These may include:

• Mild haemorrhage at the place of biopsy.
• Uncommon infection
• Temporary leakage resulting in partial collapse of the lung.
• Shortness of breath after the procedure.

Serious complications are rare. At Gleneagles Hospitals, regular monitoring ensures that problems are detected early and managed without delay.

Among the various reasons, a pleural biopsy is most beneficial for diagnostic clarity. It aids the doctors in:

• Figuring out the exact cause of pleural disease.
• Prevent unnecessary or improper treatments.
• Make proper and adequate management.
• Provide patients with direct answers about their problem.

Having a confirmed diagnosis often reduces uncertainty and anxiety for patients.

Pleural disorders are well diagnosed and treated at the Gleneagles Hospitals. The pillars of the treatment include the right diagnosis, patient safety, and compassion.

Key features include:

• Well-trained thoracic physicians and pulmonologists.
• State-of-the-art imaging and diagnostic facilities.
• Multidisciplinary complex case management across various fields.
• Effective communication and pre- and post-procedure directions.

Patients are assisted throughout the initial consultation and result review process.

Pleural biopsy is a significant tool when there are unexplained pleural conditions despite routine tests. This allows doctors to make an accurate diagnosis and establish the appropriate course of treatment by obtaining direct tissue samples.

At Gleneagles Hospitals, pleural biopsies are performed in a safe, patient-friendly, and clearly-explained manner. The patients are also provided with an opportunity to discuss their issues with medical personnel and make informed choices regarding their medication.