What Is a Lung Biopsy?

If a scan has shown a spot, shadow or area in your lung that needs a clearer answer, your team may suggest taking a tiny sample of it. That's a lung biopsy — and most of the questions people ask about it are really the same few questions, just phrased differently. So let's work through them in the order you'd probably ask them. The video at the top of this page, "Lung Biopsy" (about seven and a half minutes), shows a Spirotome macrobiopsy of the lung, described as a minimally invasive way to complete the diagnosis of lung lesions — in other words, getting tissue so the laboratory can finish the job the scan started.

Why would I need tissue at all — isn't the scan enough?

A scan is excellent at showing where something is and how big it is. What it can't reliably do is say exactly what it is. Two areas that look similar on imaging can have completely different causes — an infection, inflammation, scar tissue, or a growth — and the right next step depends on which one you're dealing with. A biopsy takes a small piece of that tissue so it can be examined under a microscope and, where needed, tested further in the lab. It's the same basic principle explained in our general guide to what a biopsy is and how results are read: imaging points, tissue answers.

What are the main ways a lung biopsy is done?

There isn't one single technique, and the choice depends on where the area sits in the lung. A needle biopsy through the skin is often used for areas near the chest wall — imaging guides the needle, and small samples are taken through it. A biopsy through the airways, using a thin flexible camera passed through the mouth, suits areas the scope can reach, and our guide to bronchoscopy explains that route in more detail. Occasionally a surgical biopsy is advised when the other routes can't reach the spot safely or a larger sample is needed. Your team will explain which route fits your scan — there's no "best" method in the abstract, only the best fit for a particular lesion in a particular person.

How does the CT-guided needle version work?

This is the version people picture most often, so it helps to slow it down. You lie on a CT scanner table while the scanner takes detailed pictures that show the radiologist exactly where the target area is. The skin is cleaned and numbed with local anaesthetic, then a fine needle is passed through the chest wall into the area shown on the scan, with further pictures checking its position as it goes. A syringe or an automated needle device then takes the small tissue sample, and you may be asked to hold your breath briefly at certain moments. The second video on this page, "CT Guided Lung Biopsy" (about five minutes), walks through exactly this set-up — the CT pictures, the needle through the skin, and the sample being taken for the laboratory. Afterwards you'll usually rest for a while and have a follow-up chest image to check the lung before you go home.

Will it hurt, and what are the risks I should know about?

The numbing injection stings briefly, and after that most people describe pressure rather than sharp pain — though you should always tell the team if you're uncomfortable, because they can adjust things. As with any procedure that passes a needle into the lung, the risks your team will discuss include a small air leak around the lung (a pneumothorax), which is why that check image afterwards matters, a small amount of bleeding or coughing up a little blood, and infection, which is uncommon. You'll be told what symptoms should prompt an urgent call once you're home — worsening breathlessness or chest pain are the ones never to sit on. If your original problem was a chest infection that wouldn't settle, our guide to pneumonia covers that background.

What happens to the sample — and when do I get an answer?

Your sample goes to the pathology laboratory, where it's prepared, stained and examined under the microscope. Sometimes extra tests are run on the same tissue, which can add a little time but saves you a second procedure. Results rarely come back the same day; your team will tell you how they'll reach you and roughly when to expect them. Whatever the answer, it comes with a plan — further treatment, another test, or simply watching the area with follow-up scans. Waiting is honestly the hardest part for most people, so ask at the appointment who to contact if you haven't heard by the date you were given.

References & further reading

MedlinePlus — Lung needle biopsy (Medical Encyclopedia): https://medlineplus.gov/ency/article/003860.htm

MedlinePlus — Biopsy: https://medlineplus.gov/biopsy.html

MedlinePlus — Lung Diseases: https://medlineplus.gov/lungdiseases.html

NHS — Biopsy: https://www.nhs.uk/conditions/biopsy/

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

Does a lung biopsy mean I have cancer?
No. A biopsy is how your team finds out what an area actually is, and lung areas turn out to have many causes besides cancer, including infection, inflammation and scarring. The test is ordered precisely because the scan alone can't settle the question.

How long does a CT-guided lung biopsy take?
The sampling itself is usually fairly quick once you're positioned and the scans have pinpointed the area, but allow longer for the whole visit — preparation, the check images afterwards and a period of rest and observation before you go home all take time.

Can I eat and drink before the biopsy?
That depends on the technique and on whether any sedation is planned, so follow the instructions in your appointment letter rather than general advice. If you take blood-thinning medicines, tell your team in advance, because they may need a plan for those.

What should I watch for after I go home?
Contact your team promptly — or seek urgent care — if you become increasingly breathless, develop chest pain, or cough up more than a small streak of blood. A little soreness where the needle went in is common and usually settles.

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. If you develop worsening breathlessness or chest pain after a biopsy, seek urgent medical care.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/14/26