Open-lung biopsy.

Abstract

OPEN biopsy of the lung through a limited thoracotomy incision deserves greater use in the diagnostic evaluation of patients with diffuse bilateral pulmonary disease, as is proven in the following examples: The pulmonary infiltrate may have been discovered only because of a routine chest roentgenogram in an otherwise asymptomatic patient. Even after careful history, physical examination, and extensive laboratory study, the diagnosis may remain obscure. Our observation has been that a patient in this category is subjected to a prolonged series of tests which are uncomfortable, expensive, and sometimes hazardous. As stated by Langston,¹the diagnostic evaluation depends upon whether the physician believes that multiple small procedures that might provide the diagnosis are better than a single major procedure that carries a high probability of establishing the diagnosis. Open-lung biopsy is recommended for those patients with diffuse pulmonary disease in whom all other reasonable diagnostic studies have been exhausted.