Integration of transbronchial cryobiopsy into multidisciplinary board decision: a single center analysis of one hundred consecutive patients with interstitial lung disease.

Autor: Hostettler KE; Clinics of Respiratory Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland. Katrin.Hostettler@usb.ch., Tamm M; Clinics of Respiratory Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland., Bubendorf L; Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, 4054, Basel, Switzerland., Grendelmeier P; Clinics of Respiratory Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland., Jahn K; Clinics of Respiratory Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland., Stolz D; Clinics of Respiratory Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland., Bremerich J; Department of Radiology, University Hospital Basel, 4031, Basel, Switzerland., Prince SS; Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, 4054, Basel, Switzerland.
Jazyk: angličtina
Zdroj: Respiratory research [Respir Res] 2021 Aug 14; Vol. 22 (1), pp. 228. Date of Electronic Publication: 2021 Aug 14.
DOI: 10.1186/s12931-021-01821-w
Abstrakt: Background: Transbronchial cryobiopsy in the evaluation of patients with interstitial lung diseases (ILD) is expected to reduce the need for surgical lung biopsy (SLB).
Objective: To evaluate the diagnostic value of cryobiopsy in combination with bronchoalveolar lavage (BAL), radiologic and clinical data in patients with ILD.
Methods: Between 08/15 and 01/20 patients with ILD underwent cryobiopsy if they: did not have (i) an usual interstitial pneumonia (UIP)-pattern on CT, (ii) predominant ground-glass opacities suggesting alveolitis, (iii) findings suggestive of sarcoidosis on CT, or if they had (i) a CT showing UIP-pattern, but had findings suggesting alternative diagnosis than idiopathic pulmonary fibrosis (IPF), or (ii) had previous non-diagnostic conventional transbronchial forceps biopsy. Histological findings were integrated into the multidisciplinary team discussion (MDTD) and a diagnostic consensus was sought.
Results: One hundred patients underwent cryobiopsy. In 88/100 patients, cryobiopsy was representative with diagnostic findings in 45/88 and non-specific histological findings in 43/88 patients. In 25/43 with non-specific findings, a consensus diagnosis was reached after MDTD integrating BAL, radiologic and clinical data; eight of the remaining 18 patients with non-specific findings were referred to SLB. In 12/100 patients cryobiopsy was not representative and three of these patients were also referred to SLB. In 7/11 patients (64%) SLB was diagnostic. Complications of cryobiopsy included pneumothorax (14%) and locally controlled bleeding (24%).
Conclusions: The diagnostic yield of cryobiopsy was 70%:45% of cryobiopsies were diagnostic based on histology alone and an additional 25% provided non-specific, but valuable findings allowing a consensus diagnosis after MDTD. Our data demonstrate that the diagnostic value of cryobiopsy is high if combined with BAL, radiologic and clinical data.
(© 2021. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje