Image-guided biopsies

A biopsy is a small sample of tissue taken so a specialist doctor, called a pathologist, can look at it under a microscope. It is often the only way to know for sure what a spot on a scan is: cancer, a harmless (benign) growth, an infection or inflammation.

Knowing the exact cause matters because it sets the treatment. With cancer, it is usually not enough to know that it is in the lung or the liver. Your doctors need to know the exact type, and often its genetic markers, to choose the right medicine.

Before any biopsy, I go through your scans myself and ask two questions. Will the result change what we do next? And what is the safest path for the needle to reach the target? If a blood test or a follow-up scan can answer the question instead, I will tell you.

Fabio Komlos, MD, interventional radiologist · About Dr. Fabio Komlos

We pick the imaging that shows your target best. Both let us watch the needle and steer it away from blood vessels, bowel and other organs.

What we see

There are two main kinds of biopsy needle. The choice depends on the organ and on what the pathologist needs.

Each biopsy has its own details, risks and recovery. Choose the page that matches your procedure.

Most of the preparation is about bleeding risk and sedation. We will call you before the procedure with instructions made for you. Our general guide is in before your procedure.

Blood thinners need a plan. For low bleeding risk biopsies, like the thyroid or a lymph node near the skin, many people keep taking them. For higher risk ones, like the lung, liver or kidney, most need to pause them for a few days. We work this out with the doctor who prescribes them. Read more in blood thinners.

1. 1
   Check-in

   At El Camino Hospital, a nurse reviews your medicines, starts an IV if you are having sedation and answers your questions. You sign a consent form.

2. 2
   Positioning and numbing

   You lie on the table in the position that gives the safest path. We clean the skin and numb it with local anesthetic, which stings for a few seconds.

3. 3
   Taking the samples

   Using ultrasound or CT, we guide the needle to the target and take several samples. You may feel pressure or hear a click from the biopsy device. We may ask you to hold your breath for a few seconds.

4. 4
   Recovery

   We close the puncture with skin glue or a small bandage. You rest for 30 minutes to a few hours, depending on the biopsy, before going home.

You can eat and drink right after. Soreness at the needle site is normal and should ease within 2 to 3 days. Acetaminophen (Tylenol) is usually enough. Avoid heavy lifting and hard exercise for about a week after most organ biopsies, or 1 to 2 days after a thyroid or lymph node biopsy.

Results usually take about 2 business days. Extra stains, genetic tests or a second opinion can add several days to a week. Cultures for infection can take up to 4 weeks. The results go to the doctor who ordered the biopsy, who will go over them with you.