Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Aug;17(2):253-7.
doi: 10.1093/icvts/ivt217. Epub 2013 May 14.

The role of surgical lung biopsy in the management of interstitial lung disease: experience from a single institution in the UK

Vivienne Blackhall  1 , Mohammed Asif, Alessandra Renieri, Serenella Civitelli, Alan Kirk, Ali Jilaihawi, Felice Granato
Affiliations

The role of surgical lung biopsy in the management of interstitial lung disease: experience from a single institution in the UK

Vivienne Blackhall et al. Interact Cardiovasc Thorac Surg. 2013 Aug.

Abstract

Objectives: Interstitial lung disease (ILD) includes a wide spectrum of pulmonary pathologies. The role of surgical lung biopsy (SLB) in the diagnosis of ILD is still controversial. The purpose of this study was to ascertain whether SLB is worthwhile in the management of ILD.

Methods: One hundred and three patients underwent SLB for ILD from April 2008 to March 2010 at a single institution. Outcomes included patient demographics, preoperative investigations, preoperative diagnosis and treatment, surgical approach, number and site of biopsies, complications, length of postoperative stay and postoperative pathological diagnosis and treatment.

Results: Fifty-one (49.6%) patients were male and 52 (50.4%) were female. The median age was 58 (range 26-78). Major complications were seen in 7 patients (6.8%). Five patients (4.9%) died within 30 days following surgery. Definitive pathological diagnosis (DPD) was reached in 72 (69.9%) patients, whereas no DPD was achieved in 31 (30.1%). Within the group of patients who received DPD, this differed from the clinical diagnosis in 53 patients (51.5%), and was concordant in 19 (18.4%). The DPD was helpful in guiding the management of 47 patients (45.6%), who had a change in their treatment following the procedure. The median hospital stay was 4 days (range 2-42 days).

Conclusions: SLB is a well-recognized procedure. Although it provides a diagnosis for the majority of patients, in our series SLB was inconclusive in a considerable number of cases and did not lead to a therapeutic change for more than half of all patients. Furthermore, SLB is not without risk and can be associated with a prolonged hospital stay. We believe that SLB should be performed in a select group of patients with ILD after discussion by a multidisciplinary panel.

Keywords: Biopsy; Interstitial lung disease; Video-assisted thoracic surgery.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Proportional breakdown of pathological diagnosis following lung biopsy. NSIP/UIP: non-specific interstitial pneumonia/usual interstitial pneumonia. LCH: Langerhans cell histiocytosis. EAA: extrinsic allergic alveolitis.
See this image and copyright information in PMC

References

    1. Lettieri C, Veerappam G, Helman D, Mulligan C, Shorr A. Outcomes and safety of surgical lung biopsy for interstitial lung disease. Chest. 2005;127:1600–5. doi:10.1378/chest.127.5.1600. - DOI - PubMed
    1. Raghu G, Mageto YN, Lockhart D, Schmidt RA, Wood DE, Godwin JD. The accuracy of the clinical diagnosis of new-onset idiopathic pulmonary fibrosis and other interstitial lung disease: a prospective study. Chest. 1999;116:1168–74. doi:10.1378/chest.116.5.1168. - DOI - PubMed
    1. Wittram C, Mark EJ, McLoud TC. CT-histologic correlation of the ATS/ERS 2002 classification of idiopathic interstitial pneumonias. Radiographics. 2003;23:1057–71. doi:10.1148/rg.235035702. - DOI - PubMed
    1. Branley HM, Lake FR. 2008 British guidelines on the management of interstitial lung diseases. What are the key new messages for clinical practice? Pol Arch Med Wewn. 2009;119:112–4. - PubMed
    1. Rena O, Casadio C, Leo F, Giobbe R, Ciani R, Baldi S, et al. Videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease. Eur J Cardiothorac Surg. 1999;16:624–7. doi:10.1016/S1010-7940(99)00320-6. - DOI - PubMed

MeSH terms