Endoscopic Diagnosis of Chest, Lung Problems

You’ve been told you need an endoscopic procedure to diagnose a problem in your chest or lung. This procedure lets your healthcare provider see the airway of your lungs and take a tissue sample (biopsy) or treat a lung condition, if needed.


A bronchoscopy lets the healthcare provider look right into the airways in your lungs. This is done using a bronchoscope. A bronchoscope is a thin, flexible, hollow, lighted tube that lets the provider see inside the lung. Tools can be passed down the middle of the scope.

Front view of trachea, bronchi, and lungs with flexible bronchoscope in trachea.
With bronchoscopy, a flexible scope allows the healthcare provider to view and biopsy the airway.

Transbronchial biopsy

This procedure is used mainly to take samples of tissue near the airway. It is done using a bronchoscope and tiny forceps. The forceps are passed through the scope into the airway, and a sample is taken.

Endobronchial ultrasound

This is a type of bronchoscopy that looks at the lungs and the space between the lungs (mediastinum). This is done using a flexible bronchoscope and ultrasound. An ultrasound makes images using sound waves. These images guide the healthcare provider and lets him or her see through the airway walls.

Getting ready for the procedure

Before your procedure, do the following:

  • Follow any directions you are given about not eating or drinking before the procedure. Also follow any directions for not smoking.

  • Tell your healthcare provider about all the medicines you take. This includes over-the-counter and prescription medicines, vitamins, herbs, and other supplements. You may need to stop taking some of them before the procedure, especially aspirin, warfarin, or other blood thinners. Ask your provider what medicines to stop taking before the procedure.

  • Talk with your provider about any allergies and health problems you have.

  • Tell your provider if you are pregnant or think you may be pregnant.

  • Tell your provider if you are breastfeeding.

During the procedure

You will get medicine through an IV (intravenous) line to help you relax and sleep during the procedure. You may also be given local anesthesia (numbing medicine) with a needle. Then a special spray is used to numb your throat and nose or mouth. This is to help keep you comfortable and prevent coughing during the procedure.

After the procedure

You are sent to the recovery room until the sedation wears off. This takes about  1 to 2 hours. Once you are fully awake, you can go home. You will need an adult family member or friend to drive you home. Your throat will be sore for a day or two. At first, there may be a small amount of blood in your sputum. This is normal. It should go away after the second day.

Risks and possible complications

Possible risks include:

  • Bleeding

  • Infection

  • Injury to vocal cords

  • Collapsed lung (pneumothorax)

When to call your healthcare provider

Call your healthcare provider if you have any of the following:

  • Large amounts of blood in sputum

  • Blood in sputum after 2 days

  • Shortness of breath

  • Chest pain

  • Fever of  100.4ºF ( 38°C) or higher, or as directed by your provider

  • Hoarseness that won’t go away

  • Symptoms that get worse, or new symptoms

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