The Characteristic of Transbronchial Lung Cryobiopsy in the Pathological Diagnosis of Hypersensitivity Pneumonitis

Autor: Shuuhei Ohno, Yoshiaki Zaizen, Goushi Matama, Tomonori Chikasue, Saeko Tokisawa, Masaki Okamoto, Kazuhiro Tabata, Masaki Tominaga, Jun Akiba, Kiminori Fujimoto, Junya Fukuoka, Tomoaki Hoshino
Rok vydání: 2023
Předmět:
Zdroj: Journal of Clinical Medicine; Volume 12; Issue 11; Pages: 3663
ISSN: 2077-0383
DOI: 10.3390/jcm12113663
Popis: Background: Transbronchial lung cryobiopsy (TBLC) has widely used for the diagnosis of diffuse lung disease. However, it remains unclear whether TBLC is useful for the diagnosis in hypersensitivity pneumonitis (HP). Methods: We investigated 18 patients who underwent TBLC and were diagnosed with HP based on pathology or multidisciplinary discussion (MDD). Of the 18 patients, 12 had fibrotic HP (fHP), 2 had non-fibrotic HP (non-fHP) diagnosed with MDD. The remaining 4 patients were diagnosed with fHP by pathology but not by MDD because of clinical features. The radiology and pathology of these cases were compared. Results: All patients with fHP showed radiological findings of inflammation, fibrosis, and airway disease. Conversely, pathology showed fibrosis and inflammation in 11 of 12 cases (92%), but airway disease was significantly less common with 5 cases (42%) (p = 0.014). Non-fHP showed inflammatory cell infiltration mainly in the centrilobule on pathology, which was consistent with radiology. Granulomas were found in 5 patients with HP (36%). In the non-HP group, airway-centered interstitial fibrosis was observed in 3 patients (75%) with pathology. Conclusions: The pathology with TBLC is difficult to evaluate airway disease of HP. We need to understand this characteristic of TBLC to make a MDD diagnosis of HP.
Databáze: OpenAIRE
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