Definition

Bronchoscopy with transbronchial biopsy is a procedure in which a bronchoscope is inserted through the nose or mouth to collect several pieces of lung tissue.

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Alternative Names

Biopsy - lung - bronchoscopic

How to prepare for the test

This test may require an overnight stay in the hospital. You must sign an informed consent form.

You should not eat for 6 to 12 hours before the test. You may be told to avoid aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or blood thinniners such as warfarin for a period of time before the procedure. Always check with your health care provider before changing or discontinuing any medications.

Arrange for transportation to and from the hospital. Many people want to rest the following day, so make arrangements for work, child care, or other obligations.

How the test will feel

Local anesthesia is used to relax your throat muscles. You may feel fluid running down the back of the throat, and feel you need to cough or gag until the anesthetic takes effect.

Despite the anesthesia, you may have sensations of pressure or mild tugging as the tube moves through the trachea. Many patients experience a feeling of suffocation when the tube is in the throat, but there is no risk of suffocation. Try to remain calm. If you cough during the test, more anesthetic will be added.

An x-ray is often taken after the bronchoscope is removed. When the anesthetic wears off, your throat may be scratchy for several days. After the test, your cough reflex will return in 1 to 2 hours, then normal eating and drinking is allowed.

It is common after a transbronchial biopsy to cough up small amounts of blood-tinged sputum for a day. The pulmonologist will give you instructions on whom to contact should you cough up significant amounts of blood.

Why the test is performed

A transbronchial biopsy is most often performed when there is diffuse infiltrative pulmonary disease, tumors, rejection of a transplanted lung, or severe illness that prevents the use of open lung biopsy.

Normal Values

The trachea and bronchi normally appear pink and smooth and have minimal secretions and no foreign bodies, growths, obstructions, or infections. The sample obtained with a transbronchial biopsy should be normal tissue from the lining of the bronchus and air sacs (alveoli).

What abnormal results mean

What the risks are

Pneumothorax occurs in about 2% of transbronchial biopsies. Usually this is followed with repeated chest x-rays unless the pneumothorax is large enough to require insertion of a chest tube to decompress the lung.

Whenever a biopsy is taken, there is a risk of hemorrhage. Some bleeding is common, and a technician or a nurse will monitor the amount of bleeding.

Lung infection may occur after any bronchoscopy.

There is also a small risk of:

If general anesthesia is used, there is also some risk of:

There is a significant risk of choking if anything (including water) is ingested before the anesthetic wears off.

Special considerations

To test whether your gag reflex has returned, place a spoon on the back of your tongue for a few seconds with light pressure. If you do not gag, wait 15 minutes and try again.

Do not use small or sharp objects to test your gag reflex. Call your health care provider or go to an emergency room immediately if you have shortness of breath or chest pain after this procedure.

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Review Date:8/7/2006
Reviewed By: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.