Clinical Analysis of Transbronchial Cryobiopsy in Diagnosis of Diffuse Lung Disease

Abstract Background: Rapid advances in TBCB in recent years have allowed its gradual acceptance as a diagnostic method for DLD, and an alternative to surgical lung biopsy . However, the various guidelines have yet to provide clear recommendations for TBCB. This study investigated the diagnostic value of transbronchial cryobiopsy (TBCB) for identifying diffuse lung disease (DLD) .Methods: The clinical data was reviewed of 34 patients who showed initial signs of diffuse lung lesions, interstitial pneumonia, bronchial asthma, lung cancer/infection, or pulmonary alveolar proteinosis; and underwent TBCB from December 2018 to March 2021. The safety and effectiveness of TBCB in identifying the etiology of DLD was analyzed.Results: Clear pathomorphological diagnoses were obtained for 27 (79.4%) patients, based on clinical characteristics and pathology: pulmonary fibrosis, adenocarcinoma, alveolar proteinosis, extrinsic allergic alveolitis, tuberculous granulomatous inflammation, and interstitial pneumonia. Four (11.8%) patients required multi-disciplinary discussion for diagnostic confirmation (of diffuse lesions, interstitial pneumonia, and lung infection). The etiology of 3 cases remained unknown. The rate of DLD diagnosis via TBCB was 91.2% (31/34). Associated with the TBCB procedure, 9 (26.5%) patients developed pneumothorax (6 mild, 3 moderate), and 29 (85.3%) post-biopsy bleeding (all grade 1, requiring suction and compression, but no other intervention or surgery). The average hospitalization cost and length of stay were 7988 RMB (1233 USD) and 5.48 days, respectively.Conclusion: TBCB is safe, cost-effective, requires a short hospitalization, and the diagnostic confirmation rate for DLD is high.

Download Full-text

Anticoagulant Use as an Independent Risk Factor and Higher In-Hospital Mortality in Patients Showing Alveolar Hemorrhage in Diffuse Lung Disease

Medicina ◽

10.3390/medicina57101094 ◽

2021 ◽

Vol 57 (10) ◽

pp. 1094

Author(s):

Motoi Ugajin ◽

Hisanori Kani ◽

Hideo Hattori

Keyword(s):

Risk Factor ◽

Hospital Mortality ◽

Lung Disease ◽

Interstitial Pneumonia ◽

Lupus Erythematosus ◽

Significant Risk ◽

Significant Risk Factor ◽

Alveolar Hemorrhage ◽

Diffuse Lung Disease ◽

Diffuse Lung

Background and objectives: Bronchoalveolar lavage (BAL) is commonly performed to evaluate diffuse lung disease and occasionally to identify alveolar hemorrhage. However, the clinical impact of alveolar hemorrhage and its risk factors in patients with diffuse lung disease have not been clarified. Materials and Methods: We retrospectively analyzed the medical records of all patients who underwent BAL to evaluate diffuse lung disease from January 2017 to December 2020. Alveolar hemorrhage was defined as progressive hemorrhagic BAL fluid or the presence of ≥20% hemosiderin-laden macrophages in the BAL fluid. Logistic regression analysis was performed to assess the association between alveolar hemorrhage and other factors. Results: Sixty subjects were enrolled in this study. Alveolar hemorrhage was observed in 19 subjects (31.7%) with idiopathic interstitial pneumonia, acute respiratory distress syndrome, interstitial pneumonia with autoimmune features, drug-induced lung injury, eosinophilic pneumonia, adenocarcinoma, and systemic lupus erythematosus. The use of anticoagulants was a significant risk factor for alveolar hemorrhage (odds ratio 7.57, p = 0.049). Patients with alveolar hemorrhage required intubated mechanical ventilation more frequently (63.2% vs. 24.4%, p = 0.005) and had higher in-hospital mortality rates (26.3% vs. 4.9%, p = 0.028) than those without alveolar hemorrhage. Conclusions: Alveolar hemorrhage was observed in various etiologies. The use of anticoagulants was a significant risk factor for alveolar hemorrhage. Patients with alveolar hemorrhage showed more severe respiratory failure and had higher in-hospital mortality than those without alveolar hemorrhage.

Download Full-text

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.

Download Full-text

Application of Multi-Slice Spiral CT in the Evaluation of Diffuse Lung Diseases

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3538 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1895-1902

Author(s):

ZanHui Jin ◽

LiYing Shen ◽

HongXing Zhao ◽

YinYuan Zheng ◽

Jian Shen

Keyword(s):

Lung Disease ◽

Lung Diseases ◽

Spiral Ct ◽

Diagnostic Value ◽

Ct Imaging ◽

Ct Image ◽

Imaging Findings ◽

Diffuse Lung Disease ◽

Diffuse Lung Diseases ◽

Diffuse Lung

This article analyzes the manifestations, characteristics, and significance of multi-slice spiral CT for diffuse lung disease, and evaluates the diagnostic value of multi-slice CT multi-directional reconstruction for diffuse lung disease. After performing multi-slice spiral CT examination on the patient and collecting relevant data, the characteristic multi-slice CT imaging findings of diffuse lung disease were determined by statistical analysis. Diffuse lung disease is representative in multi-slice spiral CT image imaging manifestations of the disease include multiple disseminated small nodules, multiple voids, ground glass shadows, and lung consolidation. And analyze the correlation of image performance, and then use statistical methods to analyze and evaluate the value of multi-slice spiral CT characteristic images in the diagnosis of diffuse lung disease, and analyze the characteristics of these characteristic multi-slice CT image appearances. The use of high-resolution CT to screen the characteristic CT imaging findings of the same research object, and then to perform a statistical analysis of the diagnostic differences with multi-slice spiral CT, further confirmed the importance of multi-slice CT for diffuse lung disease Diagnostic value. Studies have shown that multi-slice CT imaging technology is of great significance in the evaluation of diffuse lung diseases.

Download Full-text

Hantavirus Pulmonary Syndrome Is Distinguishable From Acute Interstitial Pneumonia

Archives of Pathology & Laboratory Medicine ◽

10.5858/2000-124-1463-hpsidf ◽

2000 ◽

Vol 124 (10) ◽

pp. 1463-1466

Author(s):

Thomas V. Colby ◽

Sherif R. Zaki ◽

Richard M. Feddersen ◽

Kurt B. Nolte

Keyword(s):

Viral Infection ◽

Lung Disease ◽

Interstitial Pneumonia ◽

Hantavirus Pulmonary Syndrome ◽

Pulmonary Vasculature ◽

Diffuse Lung Disease ◽

Acute Interstitial Pneumonia ◽

Clinical Presentations ◽

Acute Changes ◽

Diffuse Lung

Abstract Context.—Hantavirus pulmonary syndrome (HPS) and acute interstitial pneumonia (AIP) can share similar clinical presentations. AIP is an acute, diffuse lung disease that has some clinical features suggesting a viral infection, although causative agent(s) have not been identified. Objective.—To clinically, histologically, and immunohistochemically compare cases of HPS to cases of AIP and to determine if any cases of AIP were actually examples of HPS. Design.—Seven cases of HPS and 9 cases of AIP were compared clinically and histologically by semiquantitative grading of features in lung tissue. The cases were also evaluated immunohistochemically for the presence of hantaviral antigens. Results.—Hantavirus pulmonary syndrome had a shorter clinical duration and more acute changes histopathologically; AIP was of longer clinical duration and was usually accompanied by histologic evidence of organization. Hantavirus pulmonary syndrome was distinguished by the presence of immature leukocytes in the pulmonary vasculature. No hantaviral antigens were identified immunohistochemically in the 9 case of AIP. Hantaviral antigens were identified in all 7 cases of HPS. Conclusion.—Cases of AIP and fatal cases of HPS can generally be distinguished on clinical and histologic grounds, and this distinction can be further confirmed immunohistochemically.

Download Full-text