Having a Lung Biopsy. Department of Radiology. Information for Patients. Radiology Leaflet No. 57. University Hospitals of Leicester.

Transcription

1 Having a Lung Biopsy Department of Radiology Information for Patients i Radiology Leaflet No. 57 University Hospitals of Leicester NHS Trust

2 Contents Page number 1. Introduction 3 2. Referral and consent 3 3. What is a lung biopsy? 4 4. Why do I need a lung biopsy? 4 5. Do I need to take my normal medicines? 4 6. Information for patients with diabetes 5 7. How do I prepare for the procedure? 5 8. What happens during the procedure? 6 9. What happens after the procedure? What if I need help and advice after the procedure? Are there any risks or complications? How do I get the results? Are all biopsies successful? Other sources of information Additional information Any questions? 12 2

3 Introduction This leaflet tells you about the procedure called a lung biopsy. It explains how you decide on having the procedure carried out, what is involved, and what the possible risks are. Referral and consent The doctor who referred you should have discussed the reasons for needing a lung biopsy. You should make sure that you understand these reasons, the procedure itself, any risks involved and the success rates. The consultant or the radiologist (a specialised x-ray doctor) who will be performing the biopsy will ask you to sign a consent form. When you sign this it means you have agreed to have the biopsy done and that you understand why it is needed. You will have a copy to take away. If after discussion with your hospital doctor or radiologist you do not want the procedure carried out then you can decide against it. If you feel during the procedure that you do not want it to continue we will explain the implications of not doing so, to help you fully decide. If the radiologist feels that your condition has changed or that your symptoms do not indicate such a procedure is necessary then he/she will explain this to you, communicate with the referring doctor and ask that you return to your referring doctor for review. At all times the radiologist and referring doctor will be acting in your best interests. 3

4 What is a lung biopsy? A biopsy is a way of taking a small piece of lung tissue out of your body using only a thin needle and a tiny cut in the skin. The small piece of tissue will then be examined under a microscope by a pathologist (an expert in making a diagnosis from tissue samples). This method of taking a biopsy is sometimes called a percutaneous biopsy. Why do I need a lung biopsy? Previous x-rays or scans have shown an area of your lung may be abnormal. From the x-rays and scans it is not always possible to say exactly what the abnormality is. The simplest way of finding out is by taking a tiny piece of it away for a pathologist to examine. Do I need to take my normal medicines? If you are on medication from your doctor, please continue to take it as normal with the exception of medication that thins the blood. If you are taking medication that thins the blood please contact the Radiology Department for advice. These drugs include WARFARIN and CLOPIDOGREL (Plavix). 4

5 Information for patients with diabetes If you are diabetic it is important to have a normal breakfast. You may need to adjust your medication. Please contact your diabetes specialist nurse for advice. The diabetic helpline number is and is open Monday to Friday from 9am pm. How do I prepare for the procedure? You will have had some blood tests performed before hand to make sure that you do not have an increased risk of bleeding. You will be asked not to eat for four hours before your biopsy, though you are allowed to drink some water. Occasionally it is necessary for patients to be admitted to hospital after the biopsy. For this reason we advise that you prepare an overnight bag and bring this with you. 5

6 What happens during the procedure? The biopsy will take place in the Radiology Department in either a CT (computed tomography) scanner or ultrasound room. A needle may be put into a vein in your arm, either on the ward or when you arrive for your biopsy. This is so that you may be given medication if necessary. You will also be asked to put on a hospital gown. You will be asked to lie on the CT or ultrasound scanning table in the position that the radiologist has decided is most suitable. It is important that you stay very still in this position until the procedure is over. If you are uncomfortable please let the doctor know. Everything will be kept sterile and the radiologist will wear sterile gloves. Your skin will be cleaned with antiseptic and you will have some of your body covered with a sterile sheet. The ultrasound machine or the CT scanner will be used to decide on the best place for inserting the biopsy needle. The radiologist will look at the images while carrying out the biopsy to make sure that the needle is placed as accurately as possible. Your skin and the surrounding tissue will then be numbed with local anaesthetic and the biopsy needle will be inserted into the abnormal tissue. The first part of the procedure when the equipment is being prepared may seem to take a while but doing the biopsy itself does not take very long at all. The biopsy needle often makes a small clicking noise which should not alarm you. The radiologist will need to take two to three samples. 6

7 Will it hurt? You may feel some pain or discomfort. When the local anaesthetic is injected it will sting to start with but this wears off and the skin and deeper tissues should then feel numb. Later you may be aware of a pushing sensation as the needle is positioned but this is generally done so quickly that it does not cause much discomfort. If the procedure does become painful you should tell the person performing the biopsy and they may give you more local anaesthetic. What happens after the procedure? You will be taken back to your ward. Nurses will check your pulse, blood pressure and temperature to make sure that there are no problems. You will usually have to stay in bed for a few hours until you have recovered. You will almost certainly have a chest x-ray performed before you go home. You will not be sent home until it is considered safe to do so. Do not drive yourself home after the procedure. What if I need help and advice after the procedure? If you have any problems after the procedure please speak to the staff on the ward. If you have any problems relating to your biopsy procedure once you have left hospital please contact your GP for advice. You can also contact the lung nurse specialist. 7

8 Are there any risks or complications? As with any procedure or operation complications are possible. We have included the most common risks and complications in this leaflet. The possibility of these complications occurring will vary for each patient and the possibility of these complications happening to you will be discussed with you before you sign the consent form. It is possible that air may get into the space around the lung. If this occurs then the air may need to be drained, using either a needle or a small tube put in through the skin. This is only needed in less than 1 in 20 patients. Any biopsy carries a small risk of bleeding. If you cough up some blood after the procedure please do not be alarmed as this will stop shortly. There may be soreness around the biopsy site and some bruising. At all times during and after the procedure the staff will be monitoring your responses to this treatment in order to minimize the effects of any complications. Despite these possible complications a lung biopsy is normally very safe and can save you from having a bigger procedure which would have higher risks. How do I get the results? Your doctor (who referred you for the biopsy) is responsible for telling you about the results of your biopsy. The results take at least 2 working days. You may receive an outpatient appointment or be telephoned with the results. Please discuss with the ward nursing staff before you go home to make sure this appointment has been arranged. 8

9 Are all biopsies successful? Not all biopsies are successful. This may be because the piece of tissue has been taken from normal tissue rather than the abnormal tissue. Alternatively, the amount of abnormal tissue obtained may not be enough for the pathologist to make a definite diagnosis. The radiologist doing your biopsy may be able to give you some idea as to the possibility that a satisfactory sample has been obtained. Lung biopsies get an answer in 9 out of 10 patients. Occasionally the procedure has to be repeated or another test performed. If you require any additional information about your biopsy, please contact the Radiology Department and a radiologist will be able to discuss any queries you may have. Other sources of information Websites For general information about radiology departments visit the Royal College of Radiologists website: For information about the effects of x-rays read the publication: X-rays how safe are they on the Health Protection Agency website: Please note that the views expressed in these websites, do not necessarily reflect the views of University Hospitals of Leicester NHS Trust or the NHS. University Hospitals of Leicester web site: NHS Direct For health advice or information you can call NHS Direct on or visit the website: 9

10 Additional hospital information How was it for you? If you wish to make any comments or suggestions regarding your visit to the Radiology Department please fill in a suggestion form or speak to a member of staff. Suggestion forms are located in all waiting areas within the department. University Hospitals of Leicester NHS Trust also has a Patient Information and Liaison Service (PILS), and you are welcome to contact them on: Freephone: pils.complaints.compliments@uhl-tr.nhs.uk We review our information leaflets on a regular basis. If you have any comments about how we can improve these leaflets please speak to a member of staff. Directions and car parking Hospital car parking is available to all hospital patients and visitors. Spaces are limited so please allow plenty of time to locate a car parking space. A charge is payable. Do not drive yourself home after the procedure. Bus services There is a regular bus service from the city centre. Phone Traveline on for times and routes. A Hospital Hopper bus links the three hospitals, Beaumont Leys Centre, Hamilton Centre and the railway station. Buses run every 30 minutes between 6.30am and about 6.30pm Monday to Friday. A charge is payable for this service. 10

11 Additional hospital information (continued) Relatives and escorts You may wish to bring a friend or relative to accompany you to and from the Radiology Department when you have your examination although they may not always be allowed into the examination room. This may be useful if you do not understand English very well or if you have any special needs. Children Baby changing facilities are available. Please ask to be shown to them if you wish to use them. We are unable to offer childcare facilities. If you need to bring your children with you, please bring along somebody who can supervise them whilst your examination is being carried out. Facilities available Refreshments: refreshments including hot and cold drinks are available in the hospital. Please ask a member of staff for directions. Shops: each hospital has a shop selling magazines, newspapers, sweets and drinks. Please ask a member of staff for directions. This leaflet has been produced according to guidelines from the Royal College of Radiologists. 11

12 Any questions? If you have any questions write them down here to remind you what to ask when you speak to your consultant or radiologist. If you would like this information in another language or format, please contact the service equality manager on Haddaad rabto warqadan oo turjuman oo ku duuban cajalad ama qoraal ah fadlan la xiriir, Maamulaha Adeegga Sinaanta Eĝer bu broşürün (kitapçıĝın) yazılı veya kasetli açıklamasını isterseniz lütfen servis müdürüne telefonundan ulaşabilirsiniz. Produced by: Imaging Patient Information Group Edition 3 Implemented: March 2009 Updated: March 2012 Review: March 2015 (Goldson) KR IMA