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
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