Abstract
Introduction: Histology assessment is essential in the multidisciplinary approach of diffuse pulmonary diseases (DPD). Recently, attention has been focused on transbronchial criobiopsies (TBC), since larger and better specimens are obtained, allowing definitive diagnosis in some DPD that usually required surgical lung biopsy (SLB).
Objectives: Evaluation of TBC relevance in multidisciplinary DPD diagnosis.
Methods: Analysis of the first 59 TBC performed in DPD diagnosis context.
Results: Mean age was 59 and 52.5% were male. An average of 4 biopsies per patient were carried out, from which 79.7% were obtained in one lobe while 20.3% in two lobes. The diagnosis was conclusive in 42(71.1%) cases, avoiding referral to SLB. The most frequent diagnoses were: usual interstitial pneumonia-8, sarcoidosis-7, hypersensitive pneumonitis-6, desquamative interstitial pneumonia-5. In 17(28.8%) patients, the histological diagnosis modified the initial suspicion. Three patients whom TBC didn't allow a definitive diagnosis were submitted to SLB, and in 2, histological features were similar and a diagnosis of unclassifiable idiopathic interstitial pneumonia was established. The comlications were bleeding in 3(5.1%) patients and pneumothorax in 8(13.5%).
Conclusion: TBC proved to be useful in DPD diagnosis algorithm, associated with a low complications rate. Its diagnostic accuracy avoided SLB in a significant number of cases, corroborating the reported data in the literature. Since this technique's learning curve is considered to be the first 50 cases, TBC potential in DPD multidisciplinary diagnosis can be even higher than this series suggest.
- Copyright ©the authors 2016