Abstract
BackgroundThe usefulness and safety of transbronchial lung cryobiopsy (TBLC) for reassessment of diffuse parenchymal lung disease (DPLD) with progression is still unknown. Our purpose was to clarify the usefulness and safety of TBLC for reassessment of DPLD with progression.MethodsThis retrospective study included 31 patients with DPLD diagnosed by surgical lung biopsy who progressed in the clinical course and underwent TBLC for reassessment between January 2017 and September 2019 at Kanagawa Cardiovascular & Respiratory Center. Two pulmonologists independently selected the clinical diagnosis, treatment strategy, and confidence level of the treatment strategy based on clinical and radiological information with and without pathological information from TBLC. A consensus was reached among the pulmonologists regarding the clinical diagnosis, treatment strategy, and confidence level of the treatment strategy. Complications of TBLC were also examined.ResultsSeven (22.6%), 5 (16.1%), and 6 (19.4%) of clinical diagnosis was changed after TBLC for Pulmonologist A, for Pulmonologist B, and for consensus, respectively. The treatment strategy was changed in 7 (22.6%), 8 (25.9%), and 6 (19.4%) cases after TBLC for Pulmonologist A, for Pulmonologist B and for consensus, respectively. The definite or high confidence level of the consensus treatment strategy was 54.8% (17/31) without TBLC and 83.9% (26/31) with TBLC. There were 6 cases of moderate bleeding, but no other complications were noted.ConclusionsPathological information from TBLC may contribute to decision-making in treatment strategies for the progression of DPLD, and it may be safely performed.
Highlights
The usefulness and safety of transbronchial lung cryobiopsy (TBLC) for reassessment of diffuse parenchymal lung disease (DPLD) with progression is still unknown
The usefulness of transbronchial lung cryobiopsy (TBLC), which is safer than surgical lung biopsy (SLB), has been recognized, and a high diagnostic concordance rate with SLB has been reported in the initial diagnosis of DPLD, including idiopathic pulmonary fibrosis (IPF) [5,6,7]
At the time of TBLC, 21 patients met the definition of progressive fibrosing interstitial lung diseases (PF-ILD) in the INBUILD trial
Summary
The usefulness and safety of transbronchial lung cryobiopsy (TBLC) for reassessment of diffuse parenchymal lung disease (DPLD) with progression is still unknown. Our purpose was to clarify the usefulness and safety of TBLC for reassessment of DPLD with progression. Both idiopathic pulmonary fibrosis (IPF) and about. 20–30% of non-IPF diffuse parenchymal lung diseases (DPLD) have a poor prognosis and develop a progressive fibrosis phenotype [1]. The usefulness of transbronchial lung cryobiopsy (TBLC), which is safer than SLB, has been recognized, and a high diagnostic concordance rate with SLB has been reported in the initial diagnosis of DPLD, including IPF [5,6,7]. We conducted a retrospective study to examine the usefulness and safety of TBLC for reassessment of DPLD with progression
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