title: Transbronchial lung biopsy in patients with diffuse parenchymal lung disease without 'idiopathic pulmonary fibrosis pattern' on HRCT scan - Experience from a tertiary care center of North India.
abstract: BACKGROUND
  Diffuse parenchymal lung diseases (DPLD) are a group of disorders characterized by chest radiological findings of bilateral diffuse shadowing. Lung biopsy is generally required to make an etiological diagnosis of DPLD's. Transbronchial lung biopsy (TBLB) is a minimally invasive method to achieve a lung sample which has been found to be a useful diagnostic tool in patients with DPLD. As per American Thoracic Society guidelines for management of idiopathic interstitial pneumonias, TBLB is not required in patients who have findings consistent with idiopathic pulmonary fibrosis (IPF) on HRCT scan thorax. Some Indian researchers have evaluated, on a small number of subjects, the role of TBLB in patients with DPLD, but they had not excluded patients with 'IPF pattern'. This study was planned to assess TBLB in patients with DPLD after excluding patients with 'IPF pattern'.
  
  
  METHODS
  A prospective non-randomized study on 49 patients with DPLD without a characteristic 'IPF pattern' were subjected to TBLB.
  
  
  RESULTS
  The overall diagnostic yield of TBLB was 85.7%. Non-specific interstitial pneumonitis, tuberculosis and sarcoidosis were the most common histology patterns found (22.4, 18.4 and 16.3%, respectively). Procedure-related mortality was nil. Iatrogenic pneumothorax occurred in five patients (10.2%). Minor complications included hemorrhage and transient hypoxia.
  
  
  CONCLUSIONS
  TBLB is a safe and effective tool in the diagnosis of DPLD.
authors.affiliation: Department of Pulmonary Medicine, Guru Gobind Singh Medical College, Faridkot, Punjab, India.
authors.forename: Girish
authors.initials: G
authors.lastname: Sindhwani
authors.affiliation: Department of Pathology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
authors.forename: Nadia
authors.initials: N
authors.lastname: Shirazi
authors.affiliation: Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
authors.forename: Rakhee
authors.initials: R
authors.lastname: Sodhi
authors.affiliation: Department of Radiology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
authors.forename: Shailendra
authors.initials: S
authors.lastname: Raghuvanshi
authors.affiliation: Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
authors.forename: Jagdish
authors.initials: J
authors.lastname: Rawat
keywords: Diffuse parenchymal lung disease; idiopathic pulmonary fibrosis; transbronchial lung biopsy