Diagnostic Value of Different Biopsy Techniques in Diffuse Lung Intersetitial Diseases

Abstract

Aim: In most of the diffuse interstitial lung diseases (DILD), bronchoalveolar lavage findings are not specific. When all of the non-invasive methods are insufficient, more invasive methods may be needed for DILD diagnosis. The aim of this study was to evaluate the diagnostic value of bronchoscopic and surgical biopsies in DILD. Material-Methods: One hundred and forty subjects (80F/60M; mean age=53.25±16.14 years) with DILD were evaluated retrospectively. The diagnostic methods and the results of biopsy samples obtained via fiberoptic bronchoscopy and surgery were recorded. Statistical analyses were performed by using the SPSS version 11.0, any p value <0.05 was considered significant. Results: The diagnoses of subjects were idiopathic interstitial pneumonia (IIP) (n=76), sarcoidosis (n=37) and ILDs due to other reasons (n=27). Totally 110 bronchoscopic biopsies (64 transbronchial lung biopsies (TBLB) and 49 bronchial mucosal biopsies (BMB)) were taken. Surgical biopsies were performed in 31 cases (surgical lung biopsy (n=13) (SLB), mediastinoscopy (n=10), extrapulmonary biopsy (n=8)). The rates of definitive diagnosis for TBLB, BMB, SLB and mediastinoscopy were 26.4% (n=17), 16.3% (n=8), 92.3% (n=12) and 100% (n=10), respectively. In sarcoidosis, TBLB, BMB and SLB were positive in 50% (p=0.07), 42.8% and 75% of subjects. In IIP cases, these techniques yielded positive results in 18.9%, 8.3% and 100% of subjects, respectively. Conclusion: Transbronchial lung biopsy was more successful in the diagnosis of sarcoidosis than other ILDs. In IIP subjects without any definite diagnosis, surgical lung biopsy is needed.

Keywords

• Diffuse interstitial lung disease
• biopsy
• bronchoscopy
• surgical lung biopsy

Difüz İnterstisyel Akciğer Hastalıklarında Farklı Biyopsi Tekniklerinin Tanısal Değeri

Abstract

Amaç Bir çok difüz interstisyel akciğer hastalıklarında (DİAH), bronkoalveolar lavaj bulguları spesifik değildir. Tüm non-invaziv yöntemler yetersiz olduğunda, DİAH tanısı için daha invaziv yöntemler gerekli olabilmektedir. Bu çalışmanın amacı; DİAH'da bronkoskopik ve cerrahi biyopsilerin tanısal etkinliğini değerlendirmektir. Yöntem: DİAH olan 140 hasta (80K/60E; ortalama yaş:53.25±16.14 yıl) retrospektif olarak değerlendirildi. Tanısal yöntemler ve fiberoptik bronkoskopi veya cerrahiyle elde edilen biyopsi örneklerinin sonuçları kaydedildi. İstatistiki analizler SPSS 11,0 versiyonu kullanılarak gerçekleştirildi, p<0,05 anlamlı kabul edildi. Bulgular: Olguların tanıları idiyopatik interstisyel pnömoni (İİP) (n = 76) , sarkoidoz (n = 37) ve diğer nedenlere bağlı İAH (n = 27) idi. Toplam 110 bronkoskopik biyopsi (64 transbronşial akciğer biyopsisi (TBAB) ve 49 bronşial mukozal biyopsi (BMB)) alındı. Cerrahi biyopsiler 31 olguda gerçekleştirildi (cerrahi akciğer biyopsisi (n = 13) (CAB), mediastinoskopi (n = 10) , ekstrapulmoner biyopsi (n = 8) ) . Kesin tanı oranları TBAB, BMB,CAB ve mediastinoskopi için sırasıyla %26,4 (n = 17) %16,3 (n = 8) , %92,3 (n = 12) ve %100 (n = 10) idi. Sarkoidozda TBAB, BMB ve CAB, %50 (p=0,07), %42,8 ve %75 olguda pozitifti. İİP olgularında ise bu teknikler sırasıyla %18.9, % 8.3 ve %100 olguda pozitif sonuç verdi. Sonuç Transbronşial akciğer biyopsisi diğer interstiyel akciğer hastalıklarına göre sarkoidoz tanısında daha başarılıdır. Kesin tanı konulamayan IIP olgularında cerrahi akciğer biyopsisi gereklidir.

Keywords

• Difüz interstisyel akci􀃾er hastal􀃖klar􀃖
• biyopsi
• bronkoskopi
• cerrahi akciğer biyopsisi

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