Ultrasound Guided Needle Biopsy

J. Taylor Whaley, MD
Last Modified: December 29, 2014

What is an ultrasound-guided needle biopsy?

  • An ultrasound-guided needle biopsy is an outpatient procedure to obtain a tissue sample of an abnormality discovered on a radiology scan. This is one type of "image-guided" biopsy, which combines the use of ultrasound with either a Fine Needle Aspiration or Core Needle Biopsy.
  • An ultrasound is a radiology test that creates pictures of internal organs using sound waves. Ultrasound uses no radiation.
  • It is important to remember that just because something is abnormal does not mean it is cancer. In fact, the majority of abnormalities found on radiology tests are benign (non-cancerous). These lesions are often too small or too deep to be felt by your doctor's hands when he/she attempts to take a biopsy. For this reason, image-guidance is used to guide the needle to the right location.
  • Ultrasound-guided biopsies are generally performed as an outpatient procedure.
  • This test is most frequently used for lymph node, breast, and liver biopsies.
  • This test can also be combined with endoscopy or bronchoscopy when tumors are within the GI tract or the lungs. These are respectively known as endoscopic ultrasound (EUS) or endobronchial ultrasound (EBUS).

How is this test performed?

  • An ultrasound-guided biopsy is generally performed under local anesthesia (using numbing medicine such as lidocaine). You will be awake. A radiologist or surgeon is generally the doctor performing the test.
  • An ultrasound is done to locate the abnormality and is used to guide the needle into the lesion. The needle is then removed and contains tissue from the abnormality.
  • After the tissue is collected, the sample is placed onto a glass slide for a pathologist to study and evaluate. A pathologist is a doctor who specializes in looking at tissues under the microscope. After the pathologist has established a diagnosis, a report will be generated for your doctor.
  • The actual insertion of the needle generally takes only a few minutes. The whole procedure will take approximately 30 minutes.
  • The main risk associated with this test is bleeding. Generally, there is very little bleeding associated with the procedure, although rarely a hematoma, or pocket of blood, will collect at the site of the biopsy. This can be slightly uncomfortable but should resolve over the next few days. If there is severe pain following the procedure, you should contact your doctor immediately.
  • Additionally, there is a risk of infection and you should call your doctor if you develop a fever or the area becomes inflamed.

How do I prepare for an ultrasound-guided biopsy?

  • Frequently, no preparation is needed; however, if you are on blood thinners, your doctor will likely have you stop them several days in advance. This should be discussed when the biopsy is scheduled. Additional preparation may be required for EUS or EBUS.

How do I interpret the results of a pathology report?

  • Following the biopsy, a pathologist processes the tissue sample. A preliminary report may be given to the doctor; however, the final report generally takes several days.
  • The report generally states the patient's name, date of birth, site of biopsy, and indication (reason for the test) at the top of the report. Pathology reports follow a standard outline, regardless where they are obtained. The findings are discussed in a very systematic approach. For this reason, it is very important to discuss the results with your doctor.
    • The first paragraph typically reports the final diagnosis. This is a summary of the findings, often generated to answer the question posed by the ordering physician. If the biopsy is obtained for oncologic purposes, it commonly will state the findings are benign (not cancer), malignant (cancer), or unable to be determined.
    • The following paragraphs generally include the specific technical information involved in obtaining and processing of the sample. The details of the diagnosis can also be found here. Because reports are generated for other medical professionals, the terminology is often medically oriented and can be difficult to interpret.
    • You may want to ask for a copy of the report for your records, but you should ask your healthcare provider to review the results with you.


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