title: Do immunocompromised children benefit from having surgical lung biopsy performed?
abstract: BACKGROUND
  Surgical lung biopsy is considered a gold standard for the evaluation of pulmonary disease in immunocompromised children. However, in the literature, its accuracy and the rate of complications vary.
  
  
  OBJECTIVE
  We aimed to evaluate the yield of surgical lung biopsies in the management of persistent pulmonary findings in immunocompromised children.
  
  
  METHODS
  We performed a retrospective review of clinical records of immunocompromised children who underwent surgical lung biopsies, and evaluated the impact that preoperative factors had on outcomes.
  
  
  RESULTS
  Twenty-five patients underwent 27 surgical lung biopsies. The underlying immunodeficiency included allogeneic stem cell transplantation (n = 12), chemotherapy for solid tumors (n = 6), hematologic malignancy (n = 4), primary immunodeficiency (n = 4) and chronic steroid use (n = 1). Biopsies provided a specific histopathologic or microbiologic diagnosis in 10 cases (37%). No preoperative factor predicted a diagnostic biopsy. Five of the 27 biopsies were beneficial for the patients (18%). A major complication related to the procedure was reported for 1 biopsy (4%).
  
  
  CONCLUSIONS
  We conclude that surgical lung biopsy in pediatric immunocompromised patients appears to be safe, but has a relatively low diagnostic yield and an even lower yield with regards to the benefit it provides.
authors.affiliation: Pediatric Hemato-Oncology and Bone Marrow Transplantation, The Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel.
authors.forename: Gal
authors.initials: G
authors.lastname: Goldstein
authors.forename: Nathan
authors.initials: N
authors.lastname: Keller
authors.forename: Ron
authors.initials: R
authors.lastname: Bilik
authors.forename: Bella
authors.initials: B
authors.lastname: Bielorai
authors.forename: Amos
authors.initials: A
authors.lastname: Toren
mesh_terms: D000293:Adolescent; D064591:Allografts; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008168:Lung / Q000473:pathology* / Q000601:surgery; D008297:Male; D009369:Neoplasms / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D033581:Stem Cell Transplantation