scholarly journals The value of transbronchial lung biopsy using jumbo forceps via rigid bronchoscope in diffuse lung disease

2016 ◽  
Vol 69 (2) ◽  
Author(s):  
G.L. Casoni ◽  
C. Gurioli ◽  
P.N. Chhajed ◽  
M. Chilosi ◽  
M. Zompatori ◽  
...  
Keyword(s):  
Lung Disease ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Random Sequence ◽  
Lung Nodule ◽  
Rigid Bronchoscopy ◽  
Transbronchial Lung Biopsy ◽  
Rigid Bronchoscope ◽  
Diffuse Parenchymal Lung Disease ◽  
Diffuse Lung

Background. Transbronchial lung biopsy (TBLB) is a valuable procedure used to obtain a parenchymal specimen in the evaluation of diffuse lung infiltrates. Large forceps are expected to result in larger specimens and improve diagnostic yield. Aim. The objective of this study was to evaluate diagnostic yield of TBLB using large modified flexible gastroenterological forceps (“Jumbo forceps”) compared with ‘normal’ flexible forceps via rigid bronchoscopy in patients with diffuse parenchymal lung disease (DPLD). Methods. The study was a prospective analysis of 95 patients who underwent fluoroscopy guided TBLB over a two year period. Patients with a lung mass or solitary lung nodule undergoing TBLB were excluded. The larger and small forceps were used in a random sequence to avoid a reduction in diagnostic yield of the second series of biopsies related to possible bleeding by first series of biopsies. To minimize the consequence of haemorrhage, we performed every rigid bronchoscopy, placing a non inflated Fogarty balloon and a rigid aspirator (diameter 4 mm) in lobar bronchus near the biopsy segment. The Fogarty balloon has been inflated in case of bleeding. After the bleeding was controlled we continued to operate up to the biopsy segment. Results. Diagnostic yield of TBLB using Jumbo forceps was significantly higher than using normal flexible forceps via rigid bronchoscopy in patients with DPLD (p=0.001). In 74 out of 95 patients (78%) the diagnosis was placed with Jumbo forcep while the smaller forcep was diagnostic in 62 out of 95 patients (65%). Large forceps obtained significantly more tissue than the small forceps; the biopsy specimen taken with normal forcep measured in average 1.4 x 1.0 mm and the larger biopsy taken with jumbo forcep measured in average 2.5 x 1.9 mm (p < 0.005). Conclusion. The use of large biopsy forceps to perform TBLB via rigid bronchoscope can significantly increase diagnostic yield in the pathological diagnosis of diffuse infiltrative lung disease.

scholarly journals Transbronchial Cryobiopsy in the Diagnosis of Fibrotic Interstitial Lung Disease

2020 ◽  
Vol 144 (12) ◽  
pp. 1501-1508 ◽  
Author(s):  
Mitra Mehrad ◽  
Thomas V. Colby ◽  
Giulio Rossi ◽  
Alberto Cavazza
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Prognostic Information ◽  
Surgical Lung Biopsy ◽  
Diffuse Parenchymal Lung Disease ◽  
The Status ◽  
Pubmed Search ◽  
Parenchymal Lung Disease

Context.— Transbronchial cryobiopsy is an emerging procedure to obtain lung tissue for diagnosis of interstitial lung disease and has gained popularity because it is less invasive and has a lower rate of complications compared with nonselective surgical lung biopsy. Objective.— To provide an overview of the status of the medical literature regarding transbronchial cryobiopsy. Data Sources.— A literature search was performed using PubMed search engine. The terms “cryobiopsy” or “cryoprobe” and “interstitial lung disease” or “diffuse parenchymal lung disease” or “pulmonary fibrosis” were used, with the search concluding at the end of November 2019. Conclusions.— While the diagnostic yield of transbronchial cryobiopsy is slightly lower than surgical lung biopsy, a growing amount of literature suggests that with a multidisciplinary approach cryobiopsy provides diagnostic and prognostic information approaching that of surgical lung biopsy with lower morbidity and mortality.

Bronchoscopy in Diffuse Lung Disease: Evaluation by Open Lung Biopsy in Nondiagnostic Transbronchial Lung Biopsy

1987 ◽  
Vol 96 (6) ◽  
pp. 654-657 ◽  
Author(s):  
Ming T. Chuang ◽  
Daniel J. Krellenstein ◽  
Jonathan Raskin ◽  
Alvin S. Teirstein
Keyword(s):  
Lung Disease ◽  
Lung Biopsy ◽  
Interstitial Fibrosis ◽  
Open Lung Biopsy ◽  
Transbronchial Lung Biopsy ◽  
Flexible Bronchoscope ◽  
Diffuse Lung Disease ◽  
Open Lung ◽  
Lung Biopsies ◽  
Diffuse Lung

Transbronchial lung biopsy through the flexible bronchoscope is used widely for the diagnosis of diffuse lung disease; however, a significant number of specimens obtained by the bronchoscopic 2-mm biopsy forceps will reveal nonspecific findings, eg, interstitial fibrosis or nonspecific pneumonitis. Such a report may be an accurate reflection of the presence of idiopathic pulmonary fibrosis or nonspecific pneumonitis, but may merely indicate that the true diagnosis has been missed. We retrospectively studied 38 patients with diffuse lung disease whose transbronchial lung biopsies yielded nonspecific abnormalities. Subsequently, these patients were subjected to open lung biopsies. Nineteen of the 38 patients (50%) had a specific diagnosis made by open lung biopsy. The diagnoses included bronchiolitis obliterans, alveolar proteinosis, metastatic carcinoma, lymphoma, tuberculosis, and bronchioloalveolar cell carcinoma. Although transbronchial lung biopsy is useful in the diagnosis of many diffuse lung diseases, it is not a replacement for open lung biopsy. When nonspecific findings by transbronchial lung biopsy do not correlate with the clinical picture, open lung biopsy should be performed.

Open lung biopsy in patients on mechanical ventilation with suspected diffuse lung disease

2009 ◽  
Vol 15 (4) ◽  
pp. 597-611
Author(s):  
Natália Melo ◽  
Sandra Figueiredo ◽  
António Morais ◽  
Conceição Souto Moura ◽  
Paulo Pinho ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Lung Disease ◽  
Lung Biopsy ◽  
Open Lung Biopsy ◽  
Diffuse Lung Disease ◽  
Open Lung ◽  
Diffuse Lung
Sign in / Sign up

Export Citation Format

Share Document