Needle Biopsies for Mesothelioma Diagnosis

A needle biopsy involves medical procedures wherein cell samples from the body are collected for laboratory testing. Core needle biopsy and fine-needle aspiration are the two most commonly used needle biopsy procedures. Needle biopsy can be used to obtain fluid or tissue samples from bones, muscles and organs such as the lungs and liver.

A needle biopsy can help your doctor in diagnosing a medical condition or to deny the presence of a condition or disease. It can also be used to track and monitor progress of a treatment.

The sample obtained during the needle biopsy can help your doctor determine the cause of:

A mass or lump: Using a needle biopsy, doctors can determine if a mass or lump is an infection, a cyst, a non-cancerous (benign) tumor or cancer.
Infection: Results obtained through a needle biopsy allow doctors to identify germs that may be causing an infection. Effective medications are then administered accordingly.
Inflammation: Closely examining a needle biopsy sample can reveal the cause of inflammation and the types of cells that may be involved.

Prior to your needle biopsy, you may have to undergo a few imaging tests such as an ultrasound or a computerized tomography (CT) scan. These imaging procedures can also be carried out during the needle biopsy to help doctors locate the area or organ to be biopsied.

Risks

There are certain risks associated with a needle biopsy such as bleeding and infection that can occur at the site of needle insertion. Although some amount of mild pain may be experienced after the needle biopsy, it can be managed using prescription medications or over-the-counter pain relievers.

You need to call your doctor in case you experience:

Fever
Pain at the site of biopsy that may be worsening or cannot be controlled with medication
Swelling at the site where the needle was inserted
Fluid discharge from the site of biopsy
Bleeding that is not responding to pressure or a bandage

You must get medical help right away in case you experience:

Difficulty swallowing
Shortness of breath
Lightheadedness or fainting
Numbness of weakness in your legs

How to prepare yourself for a Biopsy?

Most types of needle biopsy procedures rarely, if ever, require you to make any preparations. However, you may be asked to follow specific guidelines such as not taking blood-thinning drugs such as aspirin or warfarin (Coumadin), in the days prior to the biopsy. Your doctor can also ask you to stop eating or drinking prior to the procedure, but that will depend on what specific part of the body is being biopsied.

How to prepare for sedation or general anesthesia

In specific cases, intravenous (IV) sedatives or general anesthesia may be administered to you prior to the needle biopsy. In this case, you may be asked to fast the day before the needle biopsy is to be conducted. Inform your doctor if you are taking any medications because you may be asked to stop taking certain medications prior to undergoing anesthesia.

If your needle biopsy is carried out under intravenous sedation or general anesthesia, you may not be able to report to work immediately. It may take you up to 24 hours to return to work depending on your duties. Ask your doctor about the time when it will be safe to report back to work.

Make proper arrangements or ask family members of friends to:

Safely drive you home
Be with you for at least 24 hours
Help you around with household chores for one or two days

What can you expect?

When the needle biopsy procedure is being carried out

The health care team members will position you in an appropriate position that will make it easier for the doctor to access the site where the needle is to be inserted. The doctor may ask you to lie down flat on a table.

In specific cases, imaging procedures such as an ultrasound or a CT scan may be carried out to help your doctor locate the target site and decide the best plan of action. In certain cases, these procedures are carried out prior to the biopsy and sometimes during the biopsy. The imaging procedure you undergo will depend on what specific part of your body has been set for biopsy.

The site where the needle is to be inserted will be cleaned by the healthcare team. An anesthesia is then injected at the targeted site to numb the area. In certain cases, an intravenous sedative or other types of drugs may be administered to make you feel relaxed during the biopsy. General anesthesia can also be used sometimes. In that case, the medication will be administered in one of the veins in your arm. This will relax you and induce a sleep-like state.

In a needle biopsy procedure, the doctor guides the needle through the skin to reach the targeted site. After collecting a sample of cells, the needle is taken out. Your doctor may keep repeating this procedure until enough cells have been obtained.

Most commonly used biopsy procedures include:

Fine-needle aspiration: A thin, hollow needle is used in this procedure to take samples of cells from your body. It is used mostly to carry out a biopsy on lumps or masses that may only require specific cells for diagnosis and not a complete tissue sample.
Core needle biopsy: A wider needle is used in this technique in comparison to fine-needle aspiration. The needle used during this procedure resembles a hollow tube that enables your doctor to draw a core tissue sample for testing. The sample allows for detailed examination of individual cells and also to find out how they might be arranged inside the tissue.

Some mild discomfort may be experienced during the needle biopsy procedure, for instance, a feeling of pressure at the site of biopsy. However, since local anesthesia is administered, it’s unlikely that you will feel pain. Inform your doctor if you experience discomfort.

After the needle biopsy procedure

The biopsy procedure is considered complete when your doctor has obtained the required amount of cells and tissue. The biopsy sample is then sent to a laboratory for clinical examination. Although results may be available within one or two days, more time may be required if some other technical tests are to be carried out.

A bandage may be applied at the site of biopsy and you may be asked to constantly apply pressure to it for several minutes in order to ensure that there is only minimal bleeding.

Generally, you can leave after the completion of your biopsy. Whether you leave soon after the completion of the biopsy or if you’ll be required to stay under observation will depend on what specific part of the body was biopsied. In certain cases, your doctor may want you to stay under observation for a few hours to make sure that complications do not occur. If IV sedative or general anesthetic was administered, you’ll be moved to a comfortable place where you can relax while waiting for the medication to wear off.

Try to relax after the biopsy has been completed. Protect the site where the biopsy was carried out by keeping the bandage fixed in place for the duration suggested by the doctor. You may experience some mild discomfort or pain in the area, but this will subside in one or two days. A pain reliever that does not contain aspirin such as acetaminophen (Tylenol, and others) can help reduce pain. You should not take aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), for example, naproxen (Aleve) and ibuprofen (Motrin, Advil and others) because these can increase chances of bleeding.

Results

Pathologists are doctors who check for signs of disease by examining cells and tissue samples. The pathologist will examine your biopsy sample in a lab, make a diagnosis and generate a pathology report to be send to your doctor. You will be contacted once the doctor has received and gone through the results.

You can ask your doctor to provide you a copy of the pathology report. However, since pathology reports generally contain technical terms, it would help if you ask your doctor to explain the technical details.

A pathology report can include:

Your medical history details: The report can have information on your medical history and details of any symptoms, based on which your doctor may have ordered a needle biopsy.
A description about the biopsy sample: Sometimes referred to as the gross description, this section provides a general description of the biopsy sample. For example, it may contain details such as the consistency and color of the fluid or tissue obtained during the needle biopsy. It may also show the total number of slides presented for laboratory analysis.
A description about the cells: In this section, a description on how the cells present themselves under a microscope is provided. For example, what types of cells and how many of them can be seen under the microscope. There may also be information on special dyes used to examine cells for gathering detailed information related to the diagnosis. Information about the most effective treatment procedures may also be there in the report.
The pathologist’s diagnosis: In this section, the diagnosis provided by the pathologist is listed. The report may also contain comments, for instance, recommendations for other types of tests.