Feasibility of CT-guided percutaneous needle biopsy in early diagnosis of BOOP.
Bronchiolitis obliterans organizing pneumonia (BOOP) is a nonneoplastic, noninfectious lung disease with a diverse spectrum of imaging abnormalities and nonspecific symptoms diagnosed by open lung biopsy, transbronchial biopsy, and/or video-assisted thoracoscopy. The objective of this study was to retrospectively assess the role of percutaneous computed tomography (CT)-guided biopsy in early diagnosis of the disorder. Fourteen BOOP cases diagnosed by CT-guided biopsy were analyzed in terms of imaging abnormalities and complication rate. All had previously undergone a nondiagnostic procedure (bronchoscopy, transbronchial biopsy, bronchoalveolar lavage) to exclude infection or lung cancer. The most common imaging abnormalities in descending order were bilateral consolidations (5/14), unilateral tumor-like lesions (5/14), unilateral consolidations (3/14), and diffuse reticular pattern (1/14). Coexistent abnormalities (pleural effusions, nodules, ground-glass opacities) were observed in five patients. The complication rate was 4 of 14 (28.6%), including 2 cases of subclinical pneumothorax and 1 case of minor hemoptysis and local lung injury. None required intervention. We conclude that transthoracic CT-guided biopsy may be used in the diagnosis of BOOP in selected patients with mild complications. For the focal consolidation nodule/mass imaging pattern, CT-guided biopsy may prove to be a reasonable alternative to more invasive procedures.
Poulou
Loukia S
LS
Department of Medical Imaging and Interventional Radiology, General Hospital of Chest Diseases Sotiria, Mesogeion Av. 152, Athens, 11527, Greece. ploukia@hotmail.com
Tsangaridou
Iris
I
Filippoussis
Petros
P
Sidiropoulou
Nektaria
N
Apostolopoulou
Sofia
S
Thanos
Loukas
L
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D015331:Cohort Studies; D018549:Cryptogenic Organizing Pneumonia / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D042241:Early Diagnosis; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*