Transbronchial Lung Cryobiopsy in the Diagnosis of Interstitial Lung Disease: A Retrospective Single-center Experience.


Journal

Journal of bronchology & interventional pulmonology
ISSN: 1948-8270
Titre abrégé: J Bronchology Interv Pulmonol
Pays: United States
ID NLM: 101496866

Informations de publication

Date de publication:
Jan 2019
Historique:
pubmed: 15 6 2018
medline: 26 3 2019
entrez: 15 6 2018
Statut: ppublish

Résumé

Surgical lung biopsy (SLB) is the gold standard to aid diagnosis of interstitial lung disease (ILD). Complication rates are restrictive as routine approach for all patients with ILD. Transbronchial lung cryobiopsy (TBLC) is presumed to be a safe, less invasive alternative to assist multidisciplinary discussions regarding the diagnosis of ILD. Varying practice patterns and lack of consistent guidelines prohibit wide support of this technique. The purpose of this study was to evaluate safety and diagnostic yield of TBLC, with highlight of distinct technical features, in ILD. Retrospective study of patients with ILD on the basis of high-resolution chest computed tomography who underwent TBLC. Of 121 TBLC, 40 patients (mean age, 57.2±13 y; 28 men) with ILD were referred for biopsy. Procedures were performed in endoscopy suite (60%) or operating room by using 1.9-mm cryoprobe. Biopsies were performed in 2 lobes with at least 3 to 5 specimens >5 mm in diameter. The average diameter and area of specimens were 5.7±2 mm and 40±2 mm, respectively. The most common diagnosis was nonspecific interstitial pneumonitis; usual interstitial pneumonia was diagnosed in 1 patient. Of 6 nondiagnostic specimens, 2 underwent SLB with subsequent diagnoses. Final histopathologic diagnostic rate was 85%. Bleeding was the most frequent complication. We provided a detailed description of our TLBC technique and highlighted areas of similarity and differences among comparative studies and attest that TBLC is a safe alternative to SLB in the diagnosis of ILD. Our data also indicated the tendency for moderate-to-severe bleeding occurred more in the endoscopy suite.

Sections du résumé

BACKGROUND BACKGROUND
Surgical lung biopsy (SLB) is the gold standard to aid diagnosis of interstitial lung disease (ILD). Complication rates are restrictive as routine approach for all patients with ILD. Transbronchial lung cryobiopsy (TBLC) is presumed to be a safe, less invasive alternative to assist multidisciplinary discussions regarding the diagnosis of ILD. Varying practice patterns and lack of consistent guidelines prohibit wide support of this technique. The purpose of this study was to evaluate safety and diagnostic yield of TBLC, with highlight of distinct technical features, in ILD.
METHODS METHODS
Retrospective study of patients with ILD on the basis of high-resolution chest computed tomography who underwent TBLC.
RESULTS RESULTS
Of 121 TBLC, 40 patients (mean age, 57.2±13 y; 28 men) with ILD were referred for biopsy. Procedures were performed in endoscopy suite (60%) or operating room by using 1.9-mm cryoprobe. Biopsies were performed in 2 lobes with at least 3 to 5 specimens >5 mm in diameter. The average diameter and area of specimens were 5.7±2 mm and 40±2 mm, respectively. The most common diagnosis was nonspecific interstitial pneumonitis; usual interstitial pneumonia was diagnosed in 1 patient. Of 6 nondiagnostic specimens, 2 underwent SLB with subsequent diagnoses. Final histopathologic diagnostic rate was 85%. Bleeding was the most frequent complication.
CONCLUSION CONCLUSIONS
We provided a detailed description of our TLBC technique and highlighted areas of similarity and differences among comparative studies and attest that TBLC is a safe alternative to SLB in the diagnosis of ILD. Our data also indicated the tendency for moderate-to-severe bleeding occurred more in the endoscopy suite.

Identifiants

pubmed: 29901529
doi: 10.1097/LBR.0000000000000514
doi:

Types de publication

Evaluation Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

15-21

Auteurs

Roy Cho (R)

Department of Interventional Pulmonary, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine.

Felix Zamora (F)

Department of Interventional Pulmonary, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine.

Heidi Gibson (H)

Division of Cardiopulmonary Services, University of Minnesota, Minneapolis, MN.

H Erhan Dincer (HE)

Department of Interventional Pulmonary, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine.

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Classifications MeSH