Outcome of Transbronchial Lung Biopsy for Patients with Respiratory Symptoms

Hadi  Mohammed; Kosar Mohammed  Ali; Kamaran  Karadakhy

doi:10.56056/amj.2019.84

Authors

Hadi Mohammed MBChB. FIBMS (Internal medicine), Respiratory Medicine Board Candidate. School of Medicine. College of Medicine. Dean of the Faculty
Kosar Mohammed Ali Assistant professor. MBChB, MRCP (UK), FRCP. Consultant Pulmonologist. University of Sulaimnyia
Kamaran Karadakhy MBChB. MD.FCCP. FRCP. Consultant Pulmonologist. University of Sulaimnyia. School of Medicine. college of Medicine

DOI:

https://doi.org/10.56056/amj.2019.84

Keywords:

C-arm fluoroscopy, Flexible bronchoscopy, Transbronchial lung biopsy

Abstract

Background and objectives: Transbronchial lung biopsy was introduced into clinical practice as a diagnostic procedure in the evaluation of diffuse lung diseases and it is relatively noninvasive and safe to obtain tissue lung biopsies. Our aim was to evaluate this procedure for the diagnosis of patients with different lung pathologies.

Methods: A prospective study of 50 cases with a variety of respiratory symptoms and chest imaging findings like mass lesions, infiltrations and consolidations, referred to our respiratory center from August 2017 to August 2018. Flexible bronchoscope and C-arm fluoroscope had been.

Results: The most common radiological findings were consolidations (34%), masses (16%) and cavitation (10%). The diagnostic yield of Transbronchial lung biopsy was 50 % of the cases, 8 cases (16 %) out of these were mycobacterium tuberculosis, 6 cases (12%) were cryptogenic organizing pneumonia ,5 cases (10%) were bronchogenic carcinoma,3 cases (6%) were usual interstitial pneumonia, 1 case (2%) was anthracosis, 1 case (2%) was sarcoidosis and 1 case (2%) was silicosis. There were just two complications,1 case (2%) developed pneu- mothorax and another one (2%) developed surgical emphysema.

Conclusions: Transbronchial lung biopsy is still a very useful safe and necessary procedure, In the absence of new technical procedures like endobronchial ultrasound or radial probe- endobronchial ultrasound, it remains an important step in the diagnosis of various lung diseases with minimal complication.

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References

Levin DC, Wicks AB, Ellis JH Jr: Transbronchial lung biopsy via the fiberoptic bronchoscope. Am Rev Respir Dis 1974; 110:4–12.

Scheinhorn DJ, Joyner LR, Whitcomb ME: Transbronchial forceps lung biopsy through the fiberoptic bronchoscope in Pneumocystis carinii pneumonia. Chest 1974; 66: 294-95.

Poletti V, Casino GL, Gurioli C, Ryu JH, Tomassetti S. Lung cryobiopsies: A paradigm shifts in diagnostic bronchoscopy? Respirology (2014) 19, 645-54.

Zavala DC. Transbronchial biopsy in diffuse lung disease. Chest. 1978; 73(Suppl:727-33).

Wahidi MM, Rocha JW, Hollingsworth A et al Contraindications and Safety of Transbronchial Lung Biopsy via Flexible Bronchoscopy Respi-ration 2005; 72:285–95.

Kalanjeri S, Holladay R, Gildea T. State-of-the-Art Modalities for Peripheral Lung Nodule Biopsy. Clin Chest Med.2018, 39;125–38.

Estarriol H, Goday R, Sánchez V, Padró B, Casamitjá Sot MT, Se- bastián Quetglás F. Bronchoscopic lung biopsy with fluoroscopy to study 164 localized pulmonary lesions. Arch Bronconeumol. 2004; 40(11):483-8.

Donald C. Zavala M. Diagnostic Fiberoptic Bronchoscopy: Techniques and Results of Biopsy in 600 Patients. Chest.1975 (68);1,12-9.

Tanner N, Yarmus L, Chen A et al. Standard Bronchoscopy with Fluoroscopy vs Thin Bronchoscopy and Radial Endobronchial Ultrasound for Biopsy of Pulmonary Lesions. Chest 2018;154(5),1035-43.

Rittirak W, Sompradeekul S. Diagnostic yield of fluoroscopy-guided transbronchial lung biopsy in non-endobronchial lung lesion.Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. J Med Assoc Thai. 2007;90 (2) :68-73.

De Roza M, Quah K, Tay C, et al Diagnosis of Peripheral Lung Lesions via Conventional Flexible Bronchoscopy with Multiplanar CT Planning. Pulmonary Medicine 2016; 2016: 5048961.

Wong M. Yasufuku K. Nakajima T. et al. Endobronchial Ultrasound: New Insight for the Diagnosis of Sarcoidosis. Europian respiratory jour- nal. 2007;29: 1182-6. doi: 10.1183/09031936.00028706.

Tsushima K, Sone S, Hanaoka T, et al. Comparison of bronchoscopic diagnosis for peripheral pulmonary nodule under fluoroscopic guidance with CT guidance. Respir Med. 2006;100 (4):737-45.

Wall CP, Gaensler EA, Carrington CB, Hayes JA. Comparison of transbronchial and open biopsies in chronic infiltrative lung diseases. Am Rev Respir Dis. 1981:123 (3):280-5.

Shim HS, Park MS, Park IK. Histopathologic findings of transbronchial biopsy in usual interstitial pneumonia. Pathol Int. 2010: 60 (5):373-7.

Gilman MJ, Wang KP. Transbronchial lung biopsy in sarcoidosis. An approach to determine the optimal number of biopsies. Am Rev Respir Dis. 1980.122 (5):721-4.

Smyth CM, Stead RJ. Survey of flexible fibreoptic bronchoscopy in the United Kingdom. Eur Respir J. 2002:19(3):458-63.

Huang Y, Huang H, Qiang Li et al. Transbronchial lung biopsy and pneumothorax. J Thorac Dis. 2014; 6(4): S443–S447.

Anders GT, Johnson JE, Bush BA, Matthews JI. Transbronchial biopsy without fluoroscopy. A 7-year perspective. Chest. 1988. 94 (3):557-60.

Torrington KC, Kern JD. The utility of fiberoptic bronchoscopy in the evaluation of the solitary pulmonary nodule. Chest. 1993; 104:1021Y1024.

Wagner U, Walthers EM, Gelmetti W. Computer-tomographically guided fiberbronchoscopic transbronchial biopsy of small pulmonary lesions: a feasibility study. Respiration. 1996; 63:181Y186.

Rong F, Cui B. CT scan directed transbronchial needle aspiration biopsy for mediastinal nodes. Chest. 1998; 114:36Y39.

Baaklini WA, Reinoso MA, Gorin AB, et al. Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest. 2000; 117:1049Y1054.

Lentz R, Argento A, Colby T, Rickman O, Maldonado F.Transbronchial cryobiopsy for diffuse parenchymal lung disease: a state-of-the-art re- view of procedural techniques, current evidence, and future challenges. Journal of Thoracic Disease. J Thorac Dis 2017;9(7):2186-203.