Abstract
Background: Transbronchial lung biopsy (TBLB) is routinely performed by pulmonologist to diagnose focal and diffuse lung diseases. Compared with open lung biopsy, TBLB has lower morbidity and mortality. The authors summarize the results of 1197 patients who underwent TBLB.
Objective: To evaluate the diagnostic yield of TBLB performed without any guidance during the procedure in various pulmonary affections.
Methods: Retrospective analysis of 1197 patients who underwent TBLB within the years 2008 to 2011. Patients were selected in groups according to a disease: focal lesion, suspected sarcoidosis, interstitial lung disease (ILD) other than sarcoidosis, pneumonia and bronchial asthma. No method of guidance during the bronchoscopy was used. The site for TBLB was chosen by a physician after revision of chest CT or chest radiograph. Results fulfilling the requested morphologic criteria of specific disease and leading to the final clinical diagnosis were judged to be true positive.
Results: The overall diagnostic yield of TBLB was 26,6 %. Highest sensitivity was observed in sarcoidosis - 60,2 %. In the subgroup of 302 patients with lung cancer, TBLB confirmed the disease in 142 (47,0 %) cases. In the ILD excluding sarcoidosis group sensitivity, specificity, positive-predictive and negative-predictive value was: 12,4 %; 92,9 %; 91,4 % and 14,8 %, respectively. In 18 persons (1,5 %) pneumothorax developed, major bleeding was observed in 7 patients (0,6 %). There was no mortality.
Conclusion: We recommend TBLB for diagnosing focal pulmonary lesions and morphologic confirmation of sarcoidosis. For its safety TBLB is a convenient method even in other diseases mainly because numerous patients can avoid surgical lung biopsy.
- © 2012 ERS
