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© Dirk Biddle
In a case where Wegener’s granulomatosis is suspected a lung biopsy may be a requirement. This may be performed in one of two ways, both under general anaesthesia.
The preferred, less invasive, method is thorascopic biopsy. This is, in effect, a variant of the percutaneous fine needle aspirant (renal) biopsy (described above) and is undertaken in much the same manner, using ultrasound as a guide. The second method is open lung surgery and “wedge” biopsy, a sizable procedure. In both cases a chest tube is post-operatively inserted into the lung to ensure lung expansion and may be left in place for 1 to 2 days to prevent the lung from collapsing. In both cases the patient is kept under observation for at least 48 hours.
Abnormal lung biopsy results may indicate cancer, benign tumours, lung diseases, and certain infections. Additional conditions under which the test may be performed include Acute pulmonary eosinophilia (Loeffler's syndrome), Chronic pulmonary coccidioidomycosis, Disseminated coccidioidomycosis, Disseminated tuberculosis (infectious), Chronic pulmonary histoplasmosis, Mesothelioma (benign-fibrous), Mesothelioma (malignant), Pneumonia with lung abscess, Primary lung cancer, Pulmonary aspergillosis, Pulmonary tuberculosis, Rheumatoid lung disease, Sarcoidosis, Viral pneumonia, Churg-Strauss syndrome and Wegener's granulomatosis (1).
Biopsy of the lining of the nose or a sinus may also be useful in the diagnosis of Wegener’s Granulomatosis.
A pleural biopsy may be undertaken concurrently (the pleura is the membrane lining the chest cavity and covering the lungs). In an open pleural biopsy, a sample of the pleura is taken through an incision made in the chest wall.
Abnormal findings can indicate tuberculosis or neoplasms (abnormal growths). Viral, fungal, or parasitic diseases may also be detected. Additional conditions under which the test may be performed include metastatic pleural tumour.
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1) http://www.nlm.nih.gov/medlineplus/ency/article/003861.htm
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