Diagnosing diffuse lung disease in children in a middle-income country: the role of open lung biopsy

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.

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Open lung biopsy in children with diffuse lung disease

Archives of Disease in Childhood ◽

10.1136/adc.49.1.27 ◽

1974 ◽

Vol 49 (1) ◽

pp. 27-35 ◽

Cited By ~ 10

Author(s):

C. J. Hewitt ◽

D. Hull ◽

J. W. Keeling

Keyword(s):

Lung Disease ◽

Lung Biopsy ◽

Open Lung Biopsy ◽

Diffuse Lung Disease ◽

Open Lung ◽

Diffuse Lung

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Open Lung Biopsy: A Safe, Reliable and Accurate Method for Diagnosis in Diffuse Lung Disease

Respiration ◽

10.1159/000196066 ◽

1992 ◽

Vol 59 (4) ◽

pp. 243-246 ◽

Cited By ~ 30

Author(s):

Samir S. Shah ◽

Victor Tsang ◽

Peter Goldstraw

Keyword(s):

Lung Disease ◽

Lung Biopsy ◽

Accurate Method ◽

Open Lung Biopsy ◽

Diffuse Lung Disease ◽

Open Lung ◽

Diffuse Lung

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Role of Lung Biopsy in Diffuse Lung Disease

Medical Management of the Thoracic Surgery Patient ◽

10.1016/b978-1-4160-3993-8.00018-0 ◽

2010 ◽

pp. 182-191

Author(s):

David Balfe

Keyword(s):

Lung Disease ◽

Lung Biopsy ◽

Diffuse Lung Disease ◽

Diffuse Lung

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The Role of Open Lung Biopsy in Diagnosis and Treatment of Diffuse Interstitial Lung Disease in High-resolution Computed Tomography Era

Tuberculosis and Respiratory Diseases ◽

10.4046/trd.1996.43.5.746 ◽

1996 ◽

Vol 43 (5) ◽

pp. 746

Author(s):

Gye Su Kim ◽

Jae Chul Lee ◽

Seung Joon Lee ◽

Chul Gyu Yoo ◽

Young Whan Kim ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Lung Biopsy ◽

Open Lung Biopsy ◽

Diagnosis And Treatment ◽

High Resolution Computed Tomography ◽

Open Lung

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ROLE OF THE OPEN LUNG BIOPSY IN THE EVALUATION OF UNDIAGNOSED ACUTE LUNG DISEASE IN A PEDIATRIC INTENSIVE CARE UNIT

Critical Care Medicine ◽

10.1097/00003246-199901001-00053 ◽

1999 ◽

Vol 27 (Supplement) ◽

pp. 42A

Author(s):

Albert Bousso ◽

Evandro R. Baldacci ◽

Jose P. Otoch ◽

Bernardo Ejzenberg ◽

Yassuhiko Okay

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Lung Disease ◽

Pediatric Intensive Care Unit ◽

Lung Biopsy ◽

Pediatric Intensive Care ◽

Open Lung Biopsy ◽

Open Lung

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Diagnosis of Diffuse Lung Disease by Cutting Needle Biopsy

Acta Radiologica ◽

10.1177/028418519403500311 ◽

1994 ◽

Vol 35 (3) ◽

pp. 251-254 ◽

Cited By ~ 4

Author(s):

P. Lohela ◽

T. Tikkakoski ◽

K. Ämmälä ◽

L. Strengell ◽

I. Suramo ◽

...

Keyword(s):

Lung Disease ◽

Needle Biopsy ◽

Lung Biopsy ◽

Open Lung Biopsy ◽

Histologic Diagnosis ◽

Diffuse Lung Disease ◽

Biopsy Device ◽

Percutaneous Lung Biopsy ◽

Diffuse Lung ◽

Cutting Needle

The results of 15 consecutive automated cutting needle (1.2 mm, n = 14; 2.0 mm, n = 1) biopsies of diffuse lung manifestations are presented. Sufficient material for histologic analysis was obtained in 13 of 15 specimens (87%) and a specific diagnosis was obtained in 11 of 14 patients (79%). The tissue specimen confirmed the clinically probable lung disease in 6 patients, gave a new, unsuspected, diagnosis in 2, and resolved a differential diagnostic problem in 3 patients. One pneumothorax after a 2.0-mm needle biopsy necessitated catheter drainage. We conclude that percutaneous lung biopsy with the automated biopsy device mounted with a 1.2-mm needle yields a histologic diagnosis with high accuracy in interstitial and alveolar lung changes, reducing the need for more invasive methods such as open lung biopsy.

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