It is best to use clinical judgement for all management decisions. Bleeding diathesis is certainly a contraindication for any form of biopsy. The risk of pneumothorax is higher in patients with COPD and blebs. However, it is only a relative contraindication. If the patient has respiratory failure, the procedure should be done as an inpatient and the chest evacuated even for a minor pneumothorax.
Anaphylactic reaction can follow rupture of an echinococcus cyst.
Therefore, needle aspiration should not be done if this diagnosis is a possibility.