Lung biopsy

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The lung biopsy is one of the diagnostic procedures in medicine . It is particularly important in the field of pulmonary medicine for the extraction of lung tissue . The tissue obtained by means of a lung biopsy can be subjected to a large number of further examinations, for example histological , cytological , immunological or genetic tests.

indication

Lung biopsy is one of the invasive diagnostic procedures. It is therefore rarely used as the first diagnostic procedure. In principle, every disease of the lung tissue that is noticeable through clinical symptoms and can be detected using radiological methods should have to be further classified using a lung biopsy. Diseases of the lung tissue include changes in the area of ​​the pulmonary vessels, the lung tissue - the parenchyma - itself or the pleura .

techniques

There are several ways to biopsy lung tissue:

Biopsies inside a lung lobe can be taken as part of a bronchoscopy: After the bronchoscope has been introduced into the lung to be examined via the pharynx and neck, the area to be biopsied is sought. A piece of the lung tissue is grasped with a biopsy forceps, cut out and pulled out through the bronchoscope. As a complication, bleeding of the biopsied lung tissue can occur. This procedure is the least invasive of the above, as no body cavities are opened. It can also be used in patients with severe health problems.

Thoracoscopy biopsies must be performed in the operating room under sterile conditions. In local anesthesia , a thoracoscope is in the through a small incision thoracic cavity introduced and withdrawn with a biopsy forceps lung tissue. In contrast to lung biopsy performed by bronchoscopy, this procedure can only be used to remove peripheral tissue located on the surface of the lung. In addition to possible bleeding in the area of ​​the biopsy, a pneumothorax or an infection of the tissue can occur as complications.

If the chest cavity is opened, it is called a thoracotomy. As with a biopsy using thoracoscopy, peripheral lung tissue can be removed. The complications correspond to those of the thoracoscopic biopsy.

With the fine needle biopsy, the area to be biopsy is localized with the help of ultrasound or CT . A hollow chamber needle, CT or ultrasound is navigated through the chest wall, pierced into the area and tissue is sucked in via the needle.

literature

E Hecker, H Dienemann: Lung biopsy - indication and choice of procedure . In: The surgeon . tape 74 , no. 8 . Springer Berlin / Heidelberg, ISSN  0009-4722 , p. 701-784 .