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Histological diagnosis of interstitial lung diseases by cryo-transbronchial biopsy.
[lymphangioleiomyomatosis]
The
gold
standard
for
the
histological
diagnosis
of
interstitial
lung
diseases
(
ILD
)
is
an
open
lung
biopsy
(
OLB
)
.
Tissue
samples
obtained
by
forceps
transbronchial
lung
biopsies
(
TBB
)
are
usually
too
small
.
We
aim
to
evaluate
the
efficacy
and
safety
of
cryo-
TBB
for
the
diagnosis
of
ILD
and
to
explore
its
role
as
substitute
for
OLB
.
Seventy
-
five
patients
(
mean
age
56
.
2
years
)
with
clinical
and
radiological
features
suggestive
of
ILD
underwent
cryo-
TBB
under
moderate
sedation
.
The
diagnostic
contribution
on
the
work-up
of
suspected
ILD
was
assessed
.
No
major
complications
occurred
during
cryo-
TBB
procedures
.
The
mean
cross-sectional
area
of
the
biopsy
specimen
obtained
was
9
mm
2
with
an
average
of
70
%
alveolated
tissue
.
The
most
common
pathological
diagnoses
were
idiopathic
nonspecific
interstitial
pneumonitis
(
n
=
22
)
,
cryptogenic
organizing
pneumonia
(
n
=
11
)
and
usual
interstitial
pneumonitis
(
n
=
7
)
.
There
were
three
patients
of
pulmonary
Langerhans
cell
histiocytosis
and
one
patient
of
pulmonary
lymphangioleiomyomatosis
.
A
definite
and
probable
clinicopathological
consensus
diagnosis
was
possible
in
70
%
and
28
%
of
patients
,
respectively
.
In
only
2
%
of
patients
'
diagnosis
could
not
be
established
.
Cryo-
TBB
is
a
safe
and
effective
minimally
invasive
modality
for
the
diagnosis
of
ILD
.
No
OLB
is
needed
in
the
majority
of
patients
.
