The role of transbronchial biopsy for the diagnosis of diffuse pneumonias in immunocompromised marrow transplant recipients

Abstract

We studied the use of transbronchial biopsy for the diagnosis of diffuse pneumonia in marrow transplant recipients. Transbronchial biopsy results were directly compared with open-lung biopsy results by performing the procedures simultaneously in the same lobe of the lung and processing the specimens in parallel. There were 24 cases of pneumonia diagnosed in 22 patients. Transbronchial biopsy correctly identified 3 of 5 cases of Pneumocystis carinii and none of the 5 cases of viral pneumonia. The overall sensitivity of transbronchial biopsy was 58%, with a 13% incidence of moderate hemorrhage and no deaths. We conclude that the open-lung biopsy remains the procedure of choice for the diagnosis of acute, diffuse pneumonia in the immunocompromised marrow transplant recipient.