Abstract
Objective: To analyze the histological quality of transbronchial lung cryobiopsy in patients with interstitial or malignant lung diseases in which a previous transbronchial lung biopsy (TBB) with conventional forceps was no diagnostic. A second objective was to analyze the cost of TBB with the flexible cryoprobe compared with surgical lung biopsy.
Patients and methods: From 01.02.2011 until 31.01.2012, 19 TBB with the flexible cryoprobe were performed. Afterwards, we analyze the cost of a TBB with the flexible cryosonde compared with surgical lung biopsy.
Results:We obtained representative material in 18/19 (95%) patients. Cryobiopsies total specimen area was 20-60 mm2 compared to TBB with forceps which was 0.5-8 mm2. Cryobiopsies did not show crush artifact in any case. In 15/19 (79%) patients we obtained a definitive diagnosis: 2 malignant tumors and 13 benign disease: 6 usual interstitial pneumonia, 1nonspecific interstitial pneumonia,1desquamative interstitial pneumonia, 1diffuse panbronchiolitis, 1 follicular bronchiolitis, 1 rheumatoid nodules, 1 respiratory bronchiolitis and 1 organizing pneumonia. In 3 patients we found some pathological findings but a definitive diagnosis was not achieved. The cost of TBB with cryobiopsy was 351€ against the cost of surgical lung biopsy which was 1189€.
Conclusions: Transbronchial cryobiopsies are larger than TBB with conventional forceps with a preserved sample because of the absence of crush artifact. Moreover, cryobiopsy is 3 times cheaper than surgical lung biopsy. Hence, transbronchial cryobiopsies could be considered as a prior step or a potentially replacing tool for the open lung biopsy.
- © 2012 ERS
