Sometimes lung cancers involve the lining tissue of the lungs (pleura) and lead to an accumulation of fluid in the space between the lungs and chest wall (called a pleural effusion). Aspiration of a sample of this fluid with a thin needle (thoracentesis) may reveal the cancer cells and establish the diagnosis. As with the needle biopsy, a small risk of a pneumothorax is associated with this procedure.
For the procedure, the patient's chest wall (usually in the back) is cleaned and numbed with a local anesthetic. Then a needle is introduced between the ribs into the pleural space and fluid is gently withdrawn. Sometimes a slightly larger needle is used for a biopsy. The fluid and/or biopsy are examined for cancer cells. Thoracentesis can also provide relief of symptoms if the patient has a large amount of fluid that is causing shortness of breath or chest pain.
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