Biopsy of the Lung

A biopsy is a short procedure during which a doctor takes a small sample of suspicious cells. A pathologist examines the tissue sample under a microscope and determines whether the cells are normal or cancerous.

In some cases, your doctor will recommend a biopsy. In others, your doctor will recommend removing the entire tumor.

We use the least invasive biopsy procedure possible, balancing the desire to minimize discomfort while still trying to obtain enough cells to make a diagnosis.

We specialize in image-guided biopsy, which uses one of our imaging technologies to precisely locate the area where we need to take the tissue sample. We offer several types of biopsy, and you may need one or more types depending on your individual case.

Image-guided biopsy

Our radiologists often use imaging to precisely locate the abnormal tissue and guide the needle for the sample. Types of imaging for guided biopsy include:

  • MRI-guided biopsy using radio waves and a magnetic field
  • Ultrasound-guided biopsy using high-frequency sound waves


In this procedure, a long, flexible tube with a small camera (endoscope) is inserted down your throat and airway and into your lung. With the bronchoscope, your doctor can view your airway and lung for irregularities and remove tissue samples for biopsy and culture.

Surgical biopsy

Your surgeon may remove part or all a tumor for testing. The goal is to determine whether the tumor is benign (noncancerous) or malignant (cancerous). Surgical biopsy may be done by a video-assisted surgical procedure ("VATS") or through a small, single incision.  Only rarely is an open thoracotomy incision required for a biopsy.

Pathology: Analyzing biopsy samples

After you have a biopsy, your nurse sends your tissue samples to our pathologists for review. A pathologist is a medical doctor who specializes in reviewing and evaluating lab tests, cells, and tissues to diagnose disease. Our pathologists analyze biopsy samples to determine whether the tissue is cancerous and, if so, what type of cancer it is.

Because cancer represents a complex group of different diseases, it’s important to have expert pathologists on your care team. Years of experience studying lung and mediastinal cancers every day means your pathologist can accurately identify critical details. This information includes whether the cancer:

  • Is invasive or noninvasive
  • Shows a high or low cell grade (rating that describes how different the cancer cells are from normal cells)
  • Is aggressive or slow growing
  • Contains molecules that indicate the cancer subtype

All these details help form an accurate diagnosis, which is vital to your treatment plan. Your care team takes the time to do a thorough evaluation from the start, so that your treatment will be more effective.

Tumor tissue bank

Our doctors and researchers work to thoroughly understand the true diversity of cancer and identify the genetic abnormalities that can play a role in cancer formation. That’s why it’s critical that our doctors have access to tissue samples to plan for each patient’s care.

At Stanford, we store tissue samples, so we can use them for research, using the following process:

  1. Usually before, but occasionally after we take a biopsy (tiny sample of tissue), we ask you if you would like to give it to the tissue bank.
  2. The tissue first goes to the laboratory, where the pathologist samples it.
  3. If you approve, the tissue then goes to cancer research specialists. These doctors work with our clinicians (doctors involved in patient care) to identify new pathways of tumor formation and possible treatments.
  4. The data is made anonymous and is not available to you after donation, because we use it for research and not for clinical use in making treatment decisions.

Our tumor bank provides our doctors and other researchers with a variety of different types of cancer cells to study. As we work on new methods and tools for diagnosing and treating cancer, our goal is to move these findings from the lab into patient care.

Stanford Health Library

For confidential help with your health care questions, contact the Stanford Health Library. Professional medical librarians and trained volunteers can help you access journals, books, e-books, databases, and videos to learn more about medical conditions, treatment options, and related issues.

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Current as of: 1/2020