Why Is a Transbronchial Biopsy Performed?

A transbronchial biopsy takes a small lung tissue sample for further lung analysis.

A transbronchial biopsy is a procedure that examines the lungs. In a transbronchial biopsy, the doctor passes a flexible telescope called a bronchoscope through the nose or mouth to cut a small piece of the lung tissue for further lung analysis. The procedure is typically used to find a problem in the lungs.

There are several reasons patients might require a transbronchial biopsy. The most common reasons are as follows:

• Tumor confirmation
• Lung changes observed on computed tomography (CT) scan or other imaging tests
• Causes for difficulty breathing such as suspected interstitial lung disease
• Suspected cause for lung transplant rejection
• Unexplained cough lasting more than three months
• Hemoptysis (coughing up blood)
• Severe lung or bronchial infections

Usually, a transbronchial biopsy is completed within one hour. However, in rare cases, the procedure may extend for a couple of hours depending on the patient’s complications. The procedure is usually done under local anesthesia and mostly as an outpatient procedure. A transbronchial biopsy is performed by a pulmonologist or lung specialist.

• The patient may be advised not to eat or drink for at least four hours prior to surgery.
• A local anesthesia gel and spray is used to numb the nose and throat. Local sedatives are used for the patient to relax during the procedure. 
• Patient’s oxygen levels and heart rate are monitored during the procedure.
• The doctor will pass a bronchoscope (flexible telescope) through the nose and down into the lungs. Sometimes, the bronchoscope will be passed through the patient’s mouth instead of their nose. 
• The doctor uses a bronchoscope to examine the patient’s bronchi (airways) and then gently pushes small forceps down one of their airways (a bronchus) into the lungs.
• The doctor will use the forceps to take samples of the lung tissue and use an X-ray machine to determine the location within the lung from which the biopsies are taken. 
• The doctor may also use small amounts of salty water to obtain other further samples for analysis. 
• The patient may have to undergo a chest X-ray after the procedure.
• Following the procedure, the samples will be examined to determine the cause of the problem.

Although the procedure carries some risks, they’re low. This test provides important diagnostic information. It may help the patient avoid a major surgery, which is much riskier.

• Complications of a transbronchial biopsy include the following:
• Allergic reaction to sedatives
• Infection
• Bleeding
• Damage to the vocal cords
• Injury to the lungs
• Irregular heart rhythms
• Pneumothorax or leaking of air from the lungs
• Heart attack
• Hypoxemia or low blood oxygen