A percutaneous (through the skin) needle biopsy is a procedure using a small needle to remove a piece of tissue from the affected organ or surrounding tissue. Common areas biopsied are the lung, liver, kidneys and adrenal glands. Biopsies are done for diagnostic purposes using either multi-detector computed tomography (MDCT or CAT scan) or ultrasound imaging. When your physician has ordered a biopsy, it is to help with the possible diagnosis of a disease process, cancer or infection.

Having a biopsy involves some possible risks. You may have bleeding or get an infection. You could also get a collapsed lung if having a liver or lung biopsy. But, if you do not have the biopsy, your physician may not know the best way to treat your illness. The interventional radiologist will explain this to you before the procedure and will answer any questions you might have.

Needle Biopsy Guidelines

When Your Procedure Is Scheduled

• Our scheduler will give you a date and time for your procedure at Overlake Hospital Medical Center. You will need to arrive at the hospital two hours before the procedure to allow the admitting and nursing staffs to get you ready.
• Please let the scheduler know if you take Coumadin, Plavix or Insulin. You will need to receive specialized instructions.
• Please notify us if you’ve had a previous reaction to contrast dye.
• If you have any questions regarding your procedure, you may call us at 425-688-5507.
• The admitting department will attempt to call you the night before your procedure to confirm your arrival time.
• Please plan to leave any jewelry or valuables at home.
• Make sure to arrange for someone to drive you home after the procedure.

Preparation

• Do not eat or drink for four hours before your exam.
• Please take your normal heart and blood pressure medications with a sip of water. You may also take any pain medication that your doctor prescribed.
• You need to be at the hospital’s admitting area two hours before you procedure’s scheduled start time. This is located at the large desk at the hospital’s main entrance (across from Stanza’s Café).
• You will be taken down to your room where you will meet your nurse. You will be asked to change into a patient gown. An IV will be started and blood drawn for lab tests. The nurse will ask you for your medical history. If possible, bring a list of all the medications you take and when you take them.
• The nurse will also ask you about allergies. If you are allergic to    radiology/contrast dye please let them know.
• If there is a possibility that you’re pregnant, please let the nurse know. You will be asked to sign a form if you are a female of childbearing age (12-57).

What to Expect During the Procedure

• The procedure takes approximately thirty minutes to one hour. You will meet the interventional radiologist who will go over the consent form and answer any questions you might still have. After looking at your previous films, the radiologist will decide if ultrasound or CT will be used for imaging guidance.
• The radiologist will numb the skin with a local anesthetic.
• You will receive sedation medication during the procedure to help you relax.
• During the procedure the nurse will be monitoring your heart, blood pressure and the oxygen level in your blood.
• The tissue that is taken will be sent to the lab for diagnosis. This will take about 2-3 days at which time a report will be sent to your physician.
• Once the procedure is over you will be transferred back to your room.

What to Expect After the Procedure

• You will have a small band aid that will be placed over the puncture site. You may remove this the next day.
• Your blood pressure, pulse and puncture site will be monitored frequently by the nurse.
• Most patients will be discharged about two to six hours after the procedure, depending on the site that was biopsied.
• You can expect some mild tenderness at the site of the biopsy which should go away in a couple of days.
• You will be given written instructions and a phone number to call if you have any questions or concerns.
• One of the interventional nurses will do a follow-up call the next week-day after your procedure. Write down any questions you might have for them.
• To speak to an interventional nurse, please call 425-688-5005. It is best to call between 8AM and 4PM Monday thru Friday. You can leave a message on the voicemail, and a nurse will return your call as soon as possible.
• If you are on Coumadin and have been told not to take it before your procedure, you need to check with your physician, and/or the Anti-Coagulation Clinic for instructions.
• If you are an insulin-dependent diabetic, restart your regular dosing when you get home. Check your sugar regularly and if you have a concern, contact your diabetic doctor.

Special Instructions If You Have a Lung Biopsy

• Once you are discharged, call the radiologist or come into the emergency room if you develop any severe shortness of breath.
• Immediately after the biopsy you will have a chest x-ray to check for a pneumothorax. This is a small collapse of the lung. Approximately one out of three patients develops this condition which needs no treatment and resolves on its own. On a rare occasion a tube will need to be placed inside the space around the lung to help re-inflate the lung. Follow-up x-rays are taken until the tube is removed.

Special Instructions If You Have a Liver Biopsy

• You can expect some soreness at the incision site and possibly into your right shoulder. This discomfort should disappear within a few days. You may take Tylenol for the discomfort. Please do not take Aspirin or Ibuprofen for 5 days after the procedure.
• If you develop a new onset of severe pain radiating to the right shoulder, please call the radiologist or come into the emergency room.

Special Instructions If You Have a Renal Biopsy

• You can expect some tenderness at the incision site; this should gradually disappear within a few days. If you pass blood clots in your urine or develop flank pain, please call the radiologist immediately for further instructions.
• Please do not take Aspirin or Ibuprofen for 5 days after procedure.