Needle Biopsy of the Pleura or Lung

ByRebecca Dezube, MD, MHS, Johns Hopkins University
Reviewed/Revised Modified Nov 2025
v11722904
VIEW PROFESSIONAL VERSION

A needle biopsy is a procedure in which a biopsy needle is inserted into the lung or through the membrane surrounding the lung (pleura) and is used to remove a piece of tissue for examination.

A needle biopsy of the pleura (pleural biopsy) may be done if thoracentesis does not uncover the cause of a pleural effusion (a fluid buildup in the space between the 2 layers of the pleura). First, the skin is cleaned and anesthetized as for thoracentesis. Ultrasound or computed tomography (CT) guidance is typically used as the doctor then uses a cutting needle to take a small sample of tissue from the pleura and sends it to a laboratory to be examined for signs of disorders, such as cancer or tuberculosis. A pleural biopsy is very accurate in diagnosing tuberculosis, but it is less accurate for diagnosing cancer and other disorders.

A needle biopsy of the lung may be done if a tissue specimen needs to be obtained from a lung tumor. After anesthetizing the skin, a doctor, often using chest computed tomography (CT), navigational bronchoscopy, or ultrasound for guidance, directs a biopsy needle into a tumor and obtains cells or a small piece of tissue to be sent to the laboratory for analysis. If a lung infection is suspected, tissue can also be sent for culture (a procedure in which a tissue sample is placed in a container containing nutrients and the container is observed to detect bacterial growth).

Complications of pleural and lung biopsies are similar to those for thoracentesis, although bleeding and air leakage into the pleural space (causing pneumothorax) are more common with biopsies than with thoracentesis.

(See also Medical History and Physical Examination for Lung Disorders and Overview of the Respiratory System.)

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