Pulmonary infiltrates in patients with haematologic malignancies: transbronchial lung biopsy increases the diagnostic yield with respect to neoplastic infiltrates and toxic pneumonitis.
We retrospectively evaluated 107 fiberoptic bronchoscopies with and without transbronchial lung biopsy (TBLB) in 98 consecutive patients with haematologic malignancies and pulmonary infiltrates. Bronchoalveolar lavage (BAL) was performed in 45 and BAL plus TBLB in 62 procedures. There was no procedure-related severe haemorrhage, pneumothorax or death. Infectious aetiology was identified in 26 of 107 (24%), toxic pneumonitis in 17 of 107 (16%) and neoplastic infiltration in 9 of 107 (8.5%) episodes. Combined BAL and TBLB was significantly superior to BAL alone with respect to the diagnosis of neoplastic infiltrates (p=0.008) and toxic pneumonitis (p<0.001) and should therefore be included in the diagnostic work-up of this patient cohort.
Mulabecirovic
A
A
Division of Rheumatology, Medical University, Auenbruggerplatz 15, 8036 Graz, Austria.
Gaulhofer
P
P
Auner
H W
HW
Popper
H
H
Krause
R
R
Hesse
C
C
Sill
H
H
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D001706:Biopsy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D001992:Bronchoalveolar Lavage Fluid; D001999:Bronchoscopy; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005336:Fiber Optic Technology; D019337:Hematologic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D017254:Leukemic Infiltration; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D017713:Platelet Transfusion; D011014:Pneumonia / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies
D000970:Antineoplastic Agents