Abstract
ABSTRACT Introduction: Transbronchial cryobiopsies (cTBB) has emerged as a new method for obtaining lung tissue biopsies in the diagnosis of interstitial lung diseases (ILDs). Until now, it has been used in a few highly specialized interventional centers and has shown promising results in obtaining a definite diagnosis of ILDs. Method: All patients undergoing a cTBB between November 2015 and June 2016 were included in this case series study. Data on patient demographics, high-resolution computed tomography patterns, size and number of biopsies, histology patterns, the contribution to a confident diagnosis and complications were registered. Results: Thirty-eight patients underwent cTBB in the period. cTBB contributed to the diagnosis in 28 (74%) of the 38 patients. Only few complications were observed; pneumothorax was the most frequent complication (10 patients, 26%). In six patients, local bleeding occurred during the procedure and was easily controlled by a Fogarty catheter balloon and in some cases tranexamic acid. Conclusion: Performing cTBB in the diagnostics of ILDs is a safe and feasible procedure. cTBB resulted in a confident diagnosis in 74% of cases.
Highlights
Transbronchial cryobiopsies has emerged as a new method for obtaining lung tissue biopsies in the diagnosis of interstitial lung diseases (ILDs)
Conventional transbronchial biopsies (TBBs) with forceps are normally recommended for diffuse perilymphatic or centrilobular diseases such as sarcoidosis, carcinomatous lymphangitis and subacute hypersensitivity pneumonia (HP)
The diagnostic yield in more peripheral and heterogeneous disorders such as those having a histological background of usual interstitial pneumonitis (UIP), non-specific interstitial pneumonitis (NSIP) and other complex morphologic features is limited due to sample size and crush artefacts.[4,5]
Summary
Transbronchial cryobiopsies (cTBB) has emerged as a new method for obtaining lung tissue biopsies in the diagnosis of interstitial lung diseases (ILDs). The diagnostic process in ILDs is multidisciplinary and typically requires a combination of radiological, pathological and clinical findings to establish a confident diagnosis. Invasive investigations such as bronchoalveolar lavage (BAL), transbronchial biopsies (TBBs) or surgical lung biopsies (SLBs) are often necessary to make a definite diagnosis.[1,2] A firm diagnosis is important for treatment decisions and has in recent years received increasing relevance after the introduction of antifibrotic treatment and reports of a detrimental treatment effect of immunosuppressive treatment in subjects with idiopathic pulmonary fibrosis (IPF).[3]. Less invasive procedures yielding comparable diagnostic information are warranted
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