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Open Lung Biopsy


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Hello Everyone;

I was scheduled to have a needle biopsy done Friday morning on a 2.9 cm nodule in my upper right lung. I got a call from the doctors office yesterday afternoon cancelling the procedure. They now want to do an open lung biopsy. They said there was to many blood vessels and bone to do the needle biopsy.

Should I read anything into this change in procedure? Surely they would not put a person through this type of procedure unless there was a very high probability of lung cancer. I just get the feeling they know a lot more than they are telling me. I realize they cannot verify anything without the biopsy but I would appreciate someone discussing their rationale with me.

I am waiting to set up counsultation with the surgeon and maybe he can shed some light on what is happening. This operation doesn't sound like much fun.

Just as an aside, I started seeing blood again while clearing my throat in the morning. I hadn't seen any for almost a week and now its back.

Once again, let me say how wonderful it is to have a place to go and get these things off my chest to people who know and understand.


Bill Lordan

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Bill, I wish I had an answer for you, but all I have are crossed fingers that the drs. just think this is the better diagnosis method based on what they see so far. The waiting is the worse. Sometimess the suspicious area is in a weird place and not accessible for a needle biopsy. From what I have heard also is that the needle biopsy is not always accurate since it can not always 'hit' the suspicious area and therefore does not get the right cells.

I wish I could tell you not to worry, that is impossible but just remember to breathe, breathe, breathe as our Snowflake would say.

Hope the tests show a big, fat nothing.

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Just my two cents on this--please see a surgeon now. He should be the one taking pieces out of your lung, if need be, or if I'm thinking the right way about an open lung biopsy, it's a biopsy performed immediately before a lobectomy, and a surgeon certainly has to be the one to do that.

My experience was, that after the chest x-ray, a CT, and a PET scan, the surgeon was 80% sure it was cancer. He would not do a biopsy because of the possible complications, which include bleeding and a collapsed lung, and because of the fact that you can get a lot of false negatives with a biopsy. He also said it needed to come out of there no matter what, so we did the surgery.

They take the nodule out while you're under general anesthetic, send it to pathology, get a frozen section and look at it under a microscope. They send the report back to the operating room, and then the surgeon proceeds with that information. In my case, it was positive, and I had a lobe and a lot of lymph nodes removed, which were sent to pathology as well. I got the preliminary report on the nodule and the nodes as soon as I woke up, and the complete pathology was ready when I went back for my follow-up visit about 10 days after discharge from the hospital.

This all seemed really extreme to me at the time, doing all that without a definate diagnosis, but now, after all I've read and heard, it is one of the appropriate ways to go.

Good luck to you and keep us posted.


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Fine Needle Aspiration Biopsy isn't without it's risks. One of those risks is the spread of malignant cells along the needle track. Most Doctors "pooh pooh" this as being minimal. But it doesn't seem such a small risk if you are the one it happens to. Also, if your tumor is very vascular shoving a large guage needle into it repeatedly may result in excessive bleeding into the lung (happened in my 3rd FNAB). In FNAB a benign pathology report on the sample doesn't mean you don't have cancer. It means that the sample they took may have missed picking up cancer cells. (Happened in my 1st FNAB). Your docs may have decided to be cautious and go with a procedure that will insure that the tumor is removed intact and with clear margins (less chance of tumor spread), and that they can examine the entire nodule for cancer cells. This will also give them better information on the type of cancer should the mass be malignant. (My 2nd FNAB pathology differed from the pathology when the entire tumor was examined. Second specimen said Large Cell, but when the whole tumor was reviewed it was Adencarcinoma with BAC Features. It is important to know what type of tumor we have, because type helps to determine the treatments available to us.)

If I had it all to do over again and knowing now what I didn't know then, I would have said "Heck NO!" to the Fine Needle Aspiration Biopsy and I would have headed straight for the OR with the whole lung coming out.

We are all entitled to our opinion on things. I'm basing my opinion re FNAB and Standard Muscle Sparing Thoracotomy on the fact that I've had three of each, plus a Right Side Anterior Thorascopy, and a Transbrochial FNAB (that in my opinion did result in seeding of tumor from the hilar lymph node to the interior lung).

Wishing you a good outcome, no matter what you decide.

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Hi Bill,

Sorry you had to come here. But I am sure you know that we are the best when it comes to support and knowledge.

My husband had the need biospy, even though they suspected LC from the beginning. For him the procedure went fine. No collapse lung or bleeding. Was home in a relativety short time.

But there can be complications. Some people wind up staying over night. See what you surgeon tells you.

Keep us posted.

Good luck to you


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Hi Bill: I have had 3 needle biopsys. All three of them were inconclusive. It was only after the surgeon cut into me (two operations) and had a pathological study done at the operating table that were they able to determine that I had cancer. For me, I guess the needle biopsys were a waste of time. Good luck.

Don M

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