Transbronchial lung biopsy in diffuse pulmonary disease

Abstract

Transbronchial lung biopsy (TBB) was performed via the fibreoptic bronchoscope in 243 patients with bilateral diffuse pulmonary shadows. Histological diagnosis was established in 54.4%. The highest diagnostic yield was obtained in sarcoidosis (73.7%), the lowest in the group of cases denoted "fibrosis" (38.7%). Statistical analysis did not allow to establish the optimal number to be taken at a single procedure but it showed that the probability of obtaining the diagnosis in sarcoidosis was 2.6% at the first specimen taken, while in fibrosis it was nul at the first and at the second specimen. The overall diagnostic yield was related to the number of cases of sarcoidosis in the material examined. Among 138 cases examined in 1984-1986, in 80 the initial biopsy failed to establish the diagnosis; in 28 of them the procedure was repeated, and positive results were obtained in 60.7% thus increasing significantly diagnostic yield. An attempt to correlate the TBB findings with bronchoalveolar lavage (BAL) showed that BAL was a valuable diagnostic factor. No major complications occurred.