Diagnostic value of combination transbronchial lung biopsy with bronchoalveolar lavage in patients with cryptogenic organizing pneumonia

Abstract

Objective To explore the clinical diagnostic value of combination transbronchial lung biopsy with bronchoalveolar lavage in patients with cryptogenic organizing pneumonia(COP). Methods Nineteen COP with biopsy-provencases were retrospectively analyzed for clinical performance, library examinations, lung functiontest and chest high-resolution computed tomography(HRCT), as well as confirmed diagnosis by transbronchial lung biopsy (TBLB). Results The mainly symptoms of respiratory system for dry cough with little sputum, short of breath or dyspnea accounted for 89.47% and 68.42% respectively.Systemic symptoms were fever and fatigue, 73.68% and 47.37% respectively.Velcro crackles on auscultation were for 63.16% cases.Erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP) increased for 68.42% and 52.63% respectively.Diffusion and restrictive ventilation dysfunctions were showed in 89.47% and 63.16% respectively.The most common chest radiographic abnormalities of COP were bilateral and multifocal areas of patchy consolidation, 1inear shadows and ground-glass opacity.T cell subsets in bronchoalvedar lavage fluid (BALF) showed a decrease in CD4/CD8 (<1.0). Positively pathological results could be obtained by TBLB for most cases.Complications of TBLB and bronchial alveolar lavage (BAL) were rare.Only a few fevers, blood in the sputum, or occasional pneumothorax occurred. Conclusions BAL and TBLB via fiberbronchoscope are safe and reliable.Early alveolar lavage and TBLB examination are important for the diagnosis of cryptogenic organizing pneumonia. Key words: Cryptogenic organizing pneumonia; Biopsy, needle; Bronchoalveolar lavage; Diagnosis