scholarly journals Surgical lung biopsy in patients with hematological malignancy or hematopoietic stem cell transplantation and unexplained pulmonary infiltrates: Improved Outcome with specific diagnosis

2005 ◽  
Vol 78 (2) ◽  
pp. 94-99 ◽  
Author(s):  
Mamoon Zihlif ◽  
Geeta Khanchandani ◽  
Huma P. Ahmed ◽  
Ayman O. Soubani
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Lung Biopsy ◽  
Hematological Malignancy ◽  
Hematopoietic Stem ◽  
Specific Diagnosis ◽  
Improved Outcome

Bronchoalveolar Lavage and Lung Biopsy in Patients With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 33 (5) ◽  
pp. 501-509 ◽  
Author(s):  
DeepakBabu Chellapandian ◽  
Thomas Lehrnbecher ◽  
Bob Phillips ◽  
Brian T. Fisher ◽  
Theoklis E. Zaoutis ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Bronchoalveolar Lavage ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Lung Biopsy ◽  
Hematopoietic Stem ◽  
Pulmonary Lesions ◽  
Patients With Cancer

Purpose The objective of this study was to describe the diagnostic yield and complication rate of bronchoalveolar lavage (BAL) and lung biopsy in the evaluation of pulmonary lesions in patients with cancer and recipients of hematopoietic stem-cell transplantation (HSCT). Methods We conducted a systematic literature review and performed electronic searches of Ovid MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials. Studies were included if patients had cancer or were recipients of HSCT, and if they underwent BAL or lung biopsy for the evaluation of pulmonary lesions. Only English language publications were included. Results In all, 14,148 studies were screened; 72 studies of BAL and 31 of lung biopsy were included. The proportion of procedures leading to any diagnosis was similar by procedure type (0.53 v 0.54; P = .94) but an infectious diagnosis was more common with BAL compared with lung biopsy (0.49 v 0.34; P < .001). Lung biopsy more commonly led to a noninfectious diagnosis (0.43 v 0.07; P < .001) and was more likely to change how the patient was managed (0.48 v 0.31; P = .002) compared with BAL. However, complications were more common with lung biopsy (0.15 v 0.08; P = .006), and procedure-related mortality was four-fold higher for lung biopsy (0.0078) compared with BAL (0.0018). Conclusion BAL may be the preferred diagnostic modality for the evaluation of potentially infectious pulmonary lesions because of lower complication and mortality rates; thus, choice of procedure depends on clinical suspicion of infection. Guidelines to promote consistency in the approach to the evaluation of lung infiltrates may improve clinical care of patients.

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