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Open pleural biopsy

Biopsy - open pleura

 

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.

How the Test is Performed

 

An open pleural biopsy is done in the hospital using general anesthesia, which means you are 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.
  • 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.

 

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.

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:

  • Abnormal tissue growth (neoplasms)
  • Disease due to a virus, fungus, or parasite
  • Mesothelioma
  • Tuberculosis

 

Risks

 

There is a slight chance of:

  • Air leak
  • Excess blood loss
  • Infection
  • Injury to the lung
  • Pneumothorax

 

 

References

Putnam JB Jr. Lung, chest wall, pleura, and mediastinum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 58.

 
  • Lungs

    Lungs - illustration

    The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

    Lungs

    illustration

  • Incision for pleural tissue biopsy

    Incision for pleural tissue biopsy - illustration

    In an open pleural biopsy, a small piece of the pleural tissue is removed through a surgical incision in the chest. After the sample is obtained, a chest tube is placed and the incision is closed with stitches. Abnormal results may indicate tuberculosis, abnormal growths, viral, fungal, and parasitic diseases.

    Incision for pleural tissue biopsy

    illustration

  • Pleural cavity

    Pleural cavity - illustration

    The pleural cavity is composed of the layers of the membrane lining the lung and the chest cavity.

    Pleural cavity

    illustration

    • Lungs

      Lungs - illustration

      The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

      Lungs

      illustration

    • Incision for pleural tissue biopsy

      Incision for pleural tissue biopsy - illustration

      In an open pleural biopsy, a small piece of the pleural tissue is removed through a surgical incision in the chest. After the sample is obtained, a chest tube is placed and the incision is closed with stitches. Abnormal results may indicate tuberculosis, abnormal growths, viral, fungal, and parasitic diseases.

      Incision for pleural tissue biopsy

      illustration

    • Pleural cavity

      Pleural cavity - illustration

      The pleural cavity is composed of the layers of the membrane lining the lung and the chest cavity.

      Pleural cavity

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Open pleural biopsy

         

         

        Review Date: 11/4/2014

        Reviewed By: John A. Daller, MD, PhD., Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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