Usefulness and safety of transbronchial lung cryobiopsy for reassessment of treatment in the clinical course of diffuse lung disease

Background Although the risk factors for diagnostic bronchoalveolar lavage (BAL)-induced acute exacerbations in patients with idiopathic pulmonary fibrosis (IPF) have been previously reported, no study has assessed these in patients with non-IPF. We aimed to identify the risk factors for BAL-induced disease deterioration (BAL-DD) in all types of diffuse lung disease. Methods Patients with diffuse lung disease who underwent BAL at our hospital from April 2012 to November 2017 were retrospectively analyzed. The patient information, laboratory data, radiological findings, and BAL fluid analysis results in patients who developed BAL-DDs were compared with those in patients who did not. Results BAL-DDs occurred in 14 (3.3%) of the 429 patients included the study. The BAL-DD group had a significantly poorer performance status, higher C-reactive protein level, lower partial pressure of oxygen in the arterial blood at rest, greater proportion of desaturation on exertion and cases having followed a progressive clinical course before BAL, and more extensive consolidation and ground-glass opacity on chest high-resolution computed tomography (HRCT) than the non-BAL-DD group. A high total cell concentration and an increased number of eosinophils in the BAL fluid were more frequently found in patients with BAL-DD than in those without. Conclusions Patients with decreased physical activity level, increased level of inflammatory markers, low oxygenation status, and extensive lung involvements on chest HRCT and following a progressive clinical course before BAL may be warned of the BAL-DD risk. Elevated eosinophil counts in the BAL fluid could be associated with the triggering of BAL-DDs.

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Feasibility, utility, and safety of transbronchial cryobiopsy for interstitial lung diseases in Japan

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2021.731 ◽

2021 ◽

Vol 16 ◽

Author(s):

Takato Ikeda ◽

Akira Nakao ◽

Fumiyasu Igata ◽

Yoshiaki Kinoshita ◽

Hisako Kushima ◽

...

Keyword(s):

Lung Disease ◽

Lung Diseases ◽

Interstitial Lung Diseases ◽

Efficacy And Safety ◽

Diffuse Lung Disease ◽

Biopsy Site ◽

Transbronchial Lung Cryobiopsy ◽

A New Technique ◽

Diffuse Lung ◽

Average Sample

Background: Transbronchial lung cryobiopsy (TBLC) is a new technique that enables larger tissue collection than can be obtained by conventional transbronchial lung biopsy. TBLC is becoming popular worldwide and is performed for diffuse lung disease and lung cancer. However, only a few reports of TBLC have been published in Japan. This study was performed to evaluate the efficacy and safety of TBLC at our hospital and compare these findings with past reports.Methods: From April 2018 to January 2020, 38 patients who underwent TBLC for diffuse lung disease at our hospital were evaluated with respect to age, sex, biopsy site, biopsy size, diagnostic disease, and complications.Results: The patients who underwent TBLC constituted 20 men and 18 women with an average age of 63.7 years. The average sample size was 5.7 mm, and the diagnostic rate was 65.7% (25/38). Grade ≥2 complications included bleeding (15.8%), pneumothorax (2.6%), and atrial fibrillation (2.6%).Conclusions: TBLC was considered to be useful for the diagnosis of diffuse lung disease and could be safely performed.

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Diffuse Lung Disease

10.1093/med/9780199755691.003.0617 ◽

2012 ◽

Author(s):

Timothy R. Aksamit

Keyword(s):

Differential Diagnosis ◽

Respiratory Failure ◽

Lung Disease ◽

Lung Diseases ◽

Clinical Course ◽

Diffuse Lung Disease ◽

Wide Range ◽

Life Threatening ◽

Diffuse Lung ◽

Parenchymal Lung

Diffuse lung disease includes a wide range of parenchymal lung diseases that have infectious, inflammatory, malignant, drug, occupational or environmental, and other causes. Although many identifiable causes are recognized, the cause of most cases of diffuse lung disease in many published series is idiopathic. The clinical course may be acute or prolonged and may progress rapidly to life-threatening respiratory failure with death, or it may be indolent over many years. In most instances, a differential diagnosis can readily be formulated by obtaining the medical history, with emphasis on the nature of the symptoms, duration, and pertinent environmental, occupational, drug, and travel exposures.

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Transbronchial Lung Biopsy through the Fiberoptic Bronchoscope in Diffuse Lung Disease

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348947508400506 ◽

1975 ◽

Vol 84 (5) ◽

pp. 596-601 ◽

Cited By ~ 1

Author(s):

Lee R. Joyner ◽

David J. Scheinhorn

Keyword(s):

Lung Disease ◽

Lung Biopsy ◽

Patient Management ◽

Clinical Course ◽

Diagnostic Value ◽

Fiberoptic Bronchoscope ◽

Diffuse Lung Disease ◽

Forceps Biopsy ◽

Parenchymal Disease ◽

Diffuse Lung

Transbronchial forceps biopsy (TBB) of the lung through the fiberoptic bronchoscope was performed in 74 patients. A histological diagnosis compatible with the clinical course, and roentgenographic appearance was obtained in 47 (64%) patients. There were six cases with inadequate tissue and ten cases where TBB was both nondiagnostic and of no other benefit in the subsequent management of the patient. This procedure was of particular value in evaluation of acutely ill patients with diffuse parenchymal disease. TBB either gave a specific diagnosis or correctly influenced patient management in 14 (89%) of 16 acutely ill patients with diffuse parenchymal disease. There was no uncontrollable hemorrhage; in one patient (15%) pneumothorax occurred. The safety and diagnostic value of this technique in the diagnosis of diffuse lung disease is proven.

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