Abstract
Background:Conventional TransBronchial Lung Biopsies(TBLB)used for diagnosis of diffuse lung diseases usually lack adequacy due to small sample size and crush artifact.Flexible cryoprobe is useful in obtaining lung biopsy bronchoscopically(FCLB).Methods:41patients who were candidates forTBLBwas included in this study in Masih Daneshvari Hospital.BothTBLBand FCLBwere performed on each patient sequentially.Histopathologic assessment was done by 2 pathologists,blindly .2dimensions were measured by microscope and area calculated mathematically.Results:The mean specimen area was5(0.2–16)mm2in TBLBs compared to20(2–100)mm2,p =0.00inFCLBs.19of41(46.34%)TBLBand1of41(2.43%)FCLB specimens were inadequate. 10 FCLBs&1TBLBS of22 adequate ones were the only diagnostic specimens.11of 22(50%)TBLBs &28of40(70%)FCLBs showed diagnostic findings including granuloma,Pneumocystis Jiroveci, Alveolar Proteinosis,Langerhans Cell Histiocytosis,Pulmonary Hemorrhage,carcinoma,IV abuse disease,aspiration ,and hypersensitivity pneumonitis.Bronchioles and acinar structures were included in 6/62 (9.67%) total adequate biopsies, all of them were FCLBs.TBLBs andFCLBs showed crush artifact(15/22=68.18%) and microscopic hemorrhage(8/40=20%)as the most common artifactual changes respectively.Intraalveolar ciliated columnar epithelial cells(7/40=17.5%)was the other artifact in FCLB group, not reported previously.
Conclusions:In comparison with TBLBs, FCLBs give larger size lung tissue and as a special morphologic finding,contain acinus and bronchiolar structures.They also have special artifacts and pathologists should be familiar with the special histomorphologic features of these specimens.
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