Abstract
Introduction: So far surgical lung biopsies are the state-of-the-art technique to obtain histological data in patients with interstitial lung disease. We analyzed whether histological specimens obtained by TCB could contribute to establishing the definite diagnosis and whether the procedure is a safe one.
Methods: A series of 20 patients showing interstitial patterns in high-resolution computertomography underwent the procedure of TCB. In all patients, 2-3 biopsies were sampled from different ipsilateral segments.
Results: In 16/20 (80%) cases the pathological findings correlated well with the suspected diagnosis according to clinical, serological, radiological and bronchoalveolar lavage fluid evaluation findings. In 4/20 (20%) patients the diagnosis remained doubtful after TCB so that these patients were subsequently forwarded to video-assisted thoracoscopic biopsy. In 3/4 (75%) of these cases the surgical lung biopsy and the TCB specimen showed the same histological pattern, therefore leading to a definite diagnosis. Regarding the safety of the studied procedure: in 4/20 (20%) patients an iatrogenic pneumothorax occurred after TCB, endobronchial bleeding was severe in 1/20 (5%) cases and moderate in 11/20 (55%) cases. Bleeding in all patients could be stopped by endoluminal application of adrenaline.
Conclusions: TCB seems to be a suitable minimal-invasive tool in the diagnostic work-up of ILD-patients with a moderate periprocedural risk.
- © 2012 ERS