There are several methods used in performing lung biopsies, depending on where the sample will be taken from and the overall health of the patient:
During this type of biopsy a lighted instrument called a bronchoscope is inserted through the mouth or nose and into the bronchial passage to remove a lung tissue sample. This method may be used if an infectious disease is suspected, if the abnormal lung tissue is located next to the bronchial tubes, or as a preliminary procedure before trying more invasive methods.
In a needle biopsy a long needle is inserted through the chest wall to remove a sample of lung tissue. This method is used if the abnormal lung tissue is located close to the chest wall. During a needle biopsy, a CT scan, ultrasound or fluoroscopy is commonly employed to guide the surgeon‘s needle with precision to the abnormal tissue.
In an open biopsy, the surgeon makes an incision between the ribs to remove a sample of lung tissue. An open biopsy is usually done when the other methods of lung biopsy have not been successful or cannot be used, or when a larger piece of lung tissue is required for diagnosis.
Video-assisted Thoracoscopic Surgery (VATS)
In VATS the surgeon uses a thoracoscope which is passed through a small incision in the chest to remove a sample of lung tissue.
In mediastinoscopy, the surgeon examines the space behind the breastbone in the middle of the chest. This area, which separates the two lungs, is known as the mediastinum, and contains lymph nodes, as well as the heart and other organs. During this procedure, using a special type of endoscope, the physician is able to locate and take a biopsy of one or more of the affected lymph nodes for microscopic examination.