[The diagnostic value of transbronchial lung biopsy in diffuse parenchymal lung diseases].
OBJECTIVE
This study was to evaluate the efficacy and limitations of transbronchial lung biopsy (TBLB) in the diagnosis of diffuse parenchymal lung diseases (DPLD).


METHODS
TBLB was performed in 416 patients with diffuse lung diseases from January 2001 to October 2006 in Peking Union Medical College Hospital. The results of clinical data and pathologic diagnosis were retrospectively analyzed.


RESULTS
Confirmed diagnosis by TBLB was obtained in 124 patients, the total positive diagnostic rate was 29.8%. The diseases included pulmonary sarcoidosis (52/124, 41.9%), bronchiolitis obliterans organizing pneumonia/organizing pneumonia (BOOP/OP) (28/124, 22.6%), pulmonary alveolar proteinosis (19/124, 15.3%), lung cancer (12/124, 9.7%), pulmonary vasculitis (5/124, 4.0%), pulmonary tuberculosis (3/124, 2.4%), and pneumocystis carinii pneumonia, lung fungal infection, lymphangiomyomatosis, and pulmonary amyloidosis (each 1/124, 0.8%). Open lung or thoracoscopic biopsy was performed in 104 cases in whom the diagnosis was undetermined by TBLB. Confirmed diagnosis was obtained in 109 patients, including nonspecific interstitial pneumonia (37/104, 37.7%), usual interstitial pneumonia (18/104, 18.4%), pulmonary sarcoidosis (11/104, 11.2%), BOOP/OP (6/104, 6.1%), and lung cancer (5/104, 5.1%).


CONCLUSIONS
Pathologic diagnosis can be obtained by TBLB in about 30% of the cases with DPLD, and therefore it should be considered to be a routine diagnostic procedure before open lung or thoracoscopic biopsy.
Shi
Ju-hong
JH
Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China.
Xu
Wen-bing
WB
Liu
Hong-rui
HR
Feng
Rui-e
RE
Zhu
Yuan-jue
YJ
Xiao
Yi
Y
Cai
Bai-qiang
BQ
D000328:Adult; D001706:Biopsy / Q000379:methods*; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000473:pathology; D012189:Retrospective Studies; D017565:Sarcoidosis, Pulmonary / Q000473:pathology; D012680:Sensitivity and Specificity; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed; D055815:Young Adult