PT  - JOURNAL ARTICLE
AU  - Gian Luca Casoni
AU  - Sara Piciucchi
AU  - Sara Tomassetti
AU  - Claudia Ravaglia
AU  - Micaela Romagnoli
AU  - Alessandra Dubini
AU  - Christian Gurioli
AU  - Paola Tantalocco
AU  - Carlo Gurioli
AU  - Alberto Cavazza
AU  - Marco Chilosi
AU  - Venerino Poletti
TI  - Pneumothorax after transbronchial lung cryobiopsy in fibrosing diffuse parenchymal lung diseases correlates with higher HRCT fibrosis score of the lower lung zones and the UIP pattern
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - 3217
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/3217.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/3217.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background Transbronchial lung cryobiopsy (TBLC) has a good diagnostic yield in the clinical-radiological setting of fibrotic diffuse parenchymal lung diseases (DPLD) without diagnostic HRCT features of usual interstitial pneumonia (UIP). However in a our published recent study we demonstrated that the pneumothorax (PNX) occurred in one-third of patients (28%) with fibrotic DPLD after TBLC.Aim of studyTo value the correlation between high-resolution computed tomography (HRCT) fibrosis score and PNX in the patients with DPLD undergoing the TBLC.MethodsHRCT fibrosis scores were valuated in 116 consecutive patients with fibrotic or non fibrotic DPLD undergoing the TBLC. The correlation between HRCT fibrosis score and cases of PNX was measured. Wilcoxon test was usedResultsPNX occurred in 28 patients (24% of total) after the cryobiopsy procedure. The majority of TBLC were performed in the right bronchial system (97 of out 116, mainly in lower lobe). Among the remaining 19 cases of TBLC performed left, 10 had PNX (53%). In the patients with PNX the TBLC histopathologic diagnoses were: 17/28 UIP pattern (61%), 8/28 nonspecific interstitial pneumonia (NSIP) pattern (29%), 2/28 hypersensitivity pneumonitis (HP) pattern (7%) and 1/28 respiratory bronchiolitis–interstitial lung disease (RB/ILD) pattern (3%). The HRCT fibrosis score of lower lung zones was significantly increased in the patients with PNX compared to those without PNX (P: 0.04).Conclusions:The striking incidence of PNX after TBLC correlates with the higher HRCT fibrosis score of the lower lung zones and the UIP pattern.