Indications, diagnostic yields and complications of transbronchial biopsy over 5 years in the State of Qatar.
OBJECTIVE
To review the indications, diagnostic yields and complications of transbronchial biopsy (TBB) in a tertiary hospital in the State of Qatar.


METHODS
A retrospective review of our records revealed 1006 adult flexible fibre optic bronchoscopies (FFB) at Hamad General Hospital, State of Qatar between January 1999 and December 2003. A total of 85 (8.4%) TBB were performed, but complete data were available for 71/85 (83.5%), which were reviewed for indications, diagnostic yields and complications.


RESULTS
Adequate samples were obtained in 58/71 TBBs (81.7%), while 13/71 TBBs (18.3%) yielded bronchial mucosa. The main indications in 16/71 (22.5%) TBBs for radiographic localized pulmonary disease were to rule out tuberculosis (TB) in 13 cases, and malignancy in 3 cases. Tuberculosis was verified in 3 (23%) of the 13 cases with localized disease. Fifty-five out of 71 (77.5%) TBBs were performed for radiographic diffuse pulmonary disease: 16/55 (29%) for miliary shadows, while 39/55 (70.9%) were carried out for reticular/reticulonodular infiltrates. Histopathology showed granulomatous lesions consistent with TB in 10/16 (62.5%) cases of miliary shadow. In the other pattern of diffuse disease, the histopathological diagnosis were obtained in 25/39 (64%) cases. It showed non-specific pulmonary fibrosis in 13 cases, sarcoidosis in 4 cases, connective tissue disease associated interstitial fibrosis in 4 cases, bronchiolitis obliterans organizing pneumonia (BOOP) in one case, eosinophilic pneumonia in one case, amiodarone toxicity in one case and lymphangitis carcinomatosis in one case. The main complications were minor bleeding <50 cc in 17 cases (23.9%), pneumothorax in 7 cases (9.8%)) and one case had sepsis.


CONCLUSIONS
Our experience substantiates previous reports of the value and safety of transbronchial biopsy in the rapid diagnosis of smear-negative miliary TB. In diffuse lung diseases of a non-infectious nature, other than sarcoidosis, lymphangitis carcinomatosis and few other conditions, a pathological diagnosis are much less likely to be reliably made on small pieces of tissue such as those provided by TBB.
Ibrahim
Abdulsalam S
AS
Department of Medicine, Hamad Medical Corporation, PO Box 3050, Doha, State of Qatar. salam145@yahoo.com
Allangawi
Mona H
MH
Sattar
Hisham A
HA
Mobyed
Hassan S
HS
Almohammed
Ahmed A
AA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000145:classification / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011780:Qatar; D012189:Retrospective Studies