Transbronchial Cryobiopsy in Interstitial Lung Disease: Are We on the Right Path?
BACKGROUND
A definitive and specific diagnosis of interstitial lung disease (ILD) often requires a histologic analysis of the lung parenchyma. A transbronchial biopsy with forceps has a limited diagnostic yield for idiopathic interstitial pneumonias. The incorporation of a transbronchial lung cryobiopsy for diagnosing ILD appears to be very promising, although there are only a few published studies in this regard. Our paper shows the results of using this technique in our center.


METHODS
This was a prospective study including 55 patients with ILD diagnosed from January 2012 to January 2015. The methodology used, the overall diagnostic yield, and the number and the location of samples, in addition to complications, have been reported.


RESULTS
In 38 (69%), 10 (20.8%), and 7 (12.7%) cases, we obtained a certain, highly likely, and unclassifiable diagnosis of interstitial pneumonia, respectively. With 18 cases, usual interstitial pneumonia was the most common diagnosis. The most common complication was a pneumothorax in 8 patients (14.5%).


CONCLUSIONS
A transbronchial lung cryobiopsy using a flexible cryoprobe has a good diagnostic yield and might be an alternative to consider in cases of diffuse ILD in which a histologic sample is required for diagnosis. This technique could avoid a large number of surgical biopsies.
Departments of *Pneumology †Pathology, Complejo Hospitalario de Navarra (Hospital Complex of Navarre), Pamplona, Navarra, Spain.
José A
JA
Cascante
Pilar
P
Cebollero
Sonia
S
Herrero
Adriana
A
Yagüe
Ana
A
Echegoyen
Jesús
J
Elizalde
Javier
J
Hueto
D000368:Aged; D001706:Biopsy; D001999:Bronchoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000453:epidemiology; D011446:Prospective Studies; D012680:Sensitivity and Specificity