Lung Biopsy: A lung biopsy is performed as a diagnostic procedure. A patient may present to his primary care physician or the hospital and they may find that this patient has a lung mass usually diagnosed by a chest x-ray and/or a CT of the chest. This may then warrant a biopsy. A lot of times, the radiology department can obtain this biopsy by using small needles. If this method proves unsatisfactory, a surgical biopsy may be needed.
The biopsy is performed by either the open (lobectomy/wedge resection) or the thoracoscopic (V.A.T.S) approach. When doing the thoracoscopic approach, 3-4 small incisions are made and a TV camera is inserted into the chest. A small piece of lung is removed. The specimen is then sent to the pathologist and is examined under a microscope. The results usually take 3-4 days to return before we give the patient a diagnosis. The patient usually has a chest tube placed at the time of the operation and may stay for 3-4 days before being removed.
Mediastinoscopy: This procedure is used to biopsy lymph nodes that are around the lung and in the chest cavity. This space is located just below the breast bone. If lung cancer is expected, or has been confirmed by a needle biopsy, sometimes the lymph nodes around the lung need to have a biopsy to see if the cancer has spread to this area. The procedure is done in the operating room under general anesthesia. A small incision is made just above the breast bone in the neck and a TV camera is inserted under the bone to the lymph nodes. A biopsy is then performed and like above, is sent to the pathologist to be examined under the microscope. No chest tube is placed in this circumstance.
