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. 2019 Sep 19;55(9):606.
doi: 10.3390/medicina55090606.

Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure

Sergio Harari  1   2 , Francesca Cereda  3 , Federico Pane  4 , Alberto Cavazza  5 , Nikolaos Papanikolaou  6 , Giuseppe Pelosi  7   8 , Monica Scarioni  9 , Elisabetta Uslenghi  10 , Maurizio Zompatori  11   12 , Antonella Caminati  13
Affiliations

Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure

Sergio Harari et al. Medicina (Kaunas). .

Abstract

Introduction: Transbronchial cryobiopsy is an alternative to surgical biopsy for the diagnosis of fibrosing interstitial lung diseases, although the role of this relatively new method is rather controversial. Aim of this study is to evaluate the diagnostic performance and the safety of transbronchial cryobiopsy in patients with fibrosing interstitial lung disease. Materials and methods: The population in this study included patients with interstitial lung diseases who underwent cryobiopsy from May 2015 to May 2018 at the Division of Pneumology of San Giuseppe Hospital in Milan and who were retrospectively studied. All cryobiopsy procedures were performed under fluoroscopic guidance using a flexible video bronchoscope and an endobronchial blocking system in the operating room with patients under general anaesthesia. The diagnostic performance and safety of the procedure were assessed. The main complications evaluated were endobronchial bleeding and pneumothorax. All cases were studied with a multidisciplinary approach, before and after cryobiopsy. Results: Seventy-three patients were admitted to this study. A specific diagnosis was reached in 64 cases, with a diagnostic sensitivity of 88%; 5 cases (7%) were considered inadequate, 4 cases (5%) were found to be non-diagnostic. Only one major bleeding event occurred (1.4%), while 14 patients (19%) experienced mild/moderate bleeding events while undergoing bronchoscopy; 8 cases of pneumothorax (10.9%) were reported, of which 2 (2.7%) required surgical drainage. Conclusions: When performed under safe conditions and in an experienced center, cryobiopsy is a procedure with limited complications having a high diagnostic yield in fibrotic interstitial lung disease.

Keywords: diagnosis; interstitial lung disease; lung biopsy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The patient is under general anaesthesia and intubated: a fibrobroncoscope and a bronchial blocker are inserted into the endotracheal tube.
Figure 2
Figure 2
The diagnostic algorithm used for the management of our cases.
See this image and copyright information in PMC

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References

    1. Raghu G., Remy-Jardin M., Myers J.L., Richeldi L., Ryerson C.J., Lederer D.J., Flaherty K.R., Behr J., Cottin V., Danoff S.K., et al. Diagnosis of idiopathic pulmonary fibrosis. An official ATS/ERS/JRS/ALAT clinical practice guideline. Am. J. Respir. Crit. Care Med. 2018;198:e44–e68. doi: 10.1164/rccm.201807-1255ST. - DOI - PubMed
    1. Hutchinson J.P., Fogarty A.W., McKeever T.M., Hubbard R.B. In-hospital mortality after surgical lung biopsy for interstitial lung disease in the United States. 2000 to 2011. Am. J. Respir. Crit. Care Med. 2016;193:1161–1167. doi: 10.1164/rccm.201508-1632OC. - DOI - PubMed
    1. Utz J.P., Ryu J.H., Douglas W.W., Hartman T.E., Tazelaar H.D., Myers J.L., Allen M.S., Schroeder D.R. High short-term mortality following lung biopsy for usual interstitial pneumonia. Eur. Respir. J. 2001;17:175–179. doi: 10.1183/09031936.01.17201750. - DOI - PubMed
    1. Guler S.A., Ellison K., Algamdi M., Collard H.R., Ryerson C.J. Heterogeneity in unclassifiable interstitial lung disease. A systematic review and meta-analysis. Ann. Am. Thorac. Soc. 2018;15:854–863. doi: 10.1513/AnnalsATS.201801-067OC. - DOI - PubMed
    1. King T.E., Jr., Bradford W.Z., Castro-Bernardini S., Fagan E.A., Glaspole I., Glassberg M.K., Lederer D.J., Gorina E., Hopkins P.M., Lederer D.J., et al. A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis. N. Engl. J. Med. 2014;370:2083–2092. doi: 10.1056/NEJMoa1402582. - DOI - PubMed