Overview

The space between your lung and the wall of your chest is called the pleural cavity or pleural space. This space is lined by a thin layer (membrane) called the pleura.

A pleural biopsy takes a sample of the pleura using a special needle. Staff in a laboratory look at this sample to diagnose any problems.

You might have a pleural biopsy if a chest X-ray or other test suggests you have:

• a build-up of fluid in your pleural cavity or space
• thickening of the pleura

You have the procedure at the hospital under local anaesthetic. This is an injection to numb the area. 

You do not usually have to stay overnight, but sometimes you might be asked to. If there are no complications, you can leave hospital straight after the procedure.

If you have any questions or concerns, please contact your pleural team.

Before a pleural biopsy

Tell your medical team if you:

• have had any previous bleeding problems
• have any allergies to medicines or latex (rubber)
• take medicines that thin the blood (such as warfarin)

If you take medicines that thin your blood, you should have been given instructions. If you did not get instructions or have any concerns, please contact your hospital team for advice.

If you take medicines that thin your blood or have a history of a bleeding disorder, you need a blood test before the procedure. We ask you to come earlier so that we can do this blood test. 

During a pleural biopsy

We ask you to remove your clothes and put on a hospital gown.

You get into a comfortable position. This might be sitting down, leaning forward and resting your arms on a table. Or it might be lying on your side.

You have an ultrasound scan to find the best place to have the biopsy.

You then have an injection to numb the area (a local anaesthetic). This might sting slightly for a short time.

When the area is numb, we make a small cut in the area. We pass a special needle through this cut and into the pleural lining.

We use the needle to take samples (biopsies) from the lining of the chest wall. We might take 3 or 4 biopsies from the area. This is not usually painful, but it might be uncomfortable. You might feel gentle pushing and pulling. 

After a pleural biopsy

You might need a chest X-ray after the procedure. This checks for any lung problems.

After the biopsy, we send the samples that we have taken to be examined in a laboratory.

It usually takes 5 to 7 days to get the results from a pleural biopsy. When your medical team have the results, they contact you to talk about them with you. 

Risks of a pleural biopsy

A biopsy is a safe procedure, but as with any procedure there are some risks. These risks are usually minor and easily treated. 

Air collecting in the pleural space (pneumothorax) happens to 4 out of every 100 people who have a pleural biopsy. The problem usually heals by itself without any treatment. However, a large amount of air might cause the lung to collapse. If this happens, we will need to put in a chest drain (a special tube). 

Pain, bleeding, bruising or infection where the needle was put in happens to less than 6 in every 100 people who have a pleural biopsy.

Bleeding in or around the lungs happens in rare cases because of the cut that we make in the chest to put in the needle. About 1 in every 500 people who have the biopsy get bleeding, which usually stops on its own. 

Other treatment options

The other option is to have a procedure called a video-assisted thoracoscopy. For this procedure, the doctor puts a camera into the space between the lung and chest wall.

You might have to stay in hospital overnight for the procedure. Your medical team can give you more information.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have a pleural biopsy, we ask you to sign a consent form. This says that you agree to have the treatment and understand what it involves.

If you would like more information about our consent process, please speak to a member of staff caring for you.