Transbronchial cryobiopsies for diagnosing interstitial lung disease

• Verfasst von: Wälscher, Julia [VerfasserIn]
• Verfasst von: Groß, Benjamin [VerfasserIn]
• Verfasst von: Eberhardt, Ralf [VerfasserIn]
• Verfasst von: Heußel, Claus Peter [VerfasserIn]
• Verfasst von: Eichinger, Monika [VerfasserIn]
• Verfasst von: Lasitschka, Felix [VerfasserIn]
• Verfasst von: Herth, Felix [VerfasserIn]
• Verfasst von: Kreuter, Michael [VerfasserIn]
• Titel: Transbronchial cryobiopsies for diagnosing interstitial lung disease
• Titelzusatz: real-life experience from a tertiary referral center for interstitial lung disease
• Verf.angabe: Julia Wälscher, Benjamin Groß, Ralf Eberhardt, Claus Peter Heussel, Monika Eichinger, Arne Warth, Felix Lasitschka, Felix J.F. Herth, Michael Kreuter
• E-Jahr: 2019
• Jahr: February 2019
• Umfang: 7 S.
• Fussnoten: Gesehen am 26.04.2019
• Titel Quelle: Enthalten in: Respiration
• Ort Quelle: Basel : Karger, 1968
• Jahr Quelle: 2019
• Band/Heft Quelle: 97(2019), 4, Seite 348-354
• ISSN Quelle: 1423-0356
• DOI: doi:10.1159/000493428
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Bronchoscopy
• Sach-SW: Cryobiopsy
• Sach-SW: Interstitial lung disease
• Sach-SW: Multidisciplinary team
• K10plus-PPN: 1663651280

Abstract

BACKGROUND: Transbronchial cryobiopsy (cTBB) may offer an alternative to surgical lung biopsy (SLB) for histopathological diagnosis of interstitial lung diseases (ILDs). However, real-life experience is limited, although case series are increasingly reported. - OBJECTIVES: We aimed to evaluate the value of cTBB performed under real-life conditions in a tertiary care center for ILDs. - METHODS: Data on all patients undergoing a cTBB for evaluation of suspected ILD between October 2015 and January 2017 were included in this retrospective case series. Procedure details, complication rates, histopathological results, and diagnostic consensus reached by a multidisciplinary team (MDT) discussion were collated and evaluated. - RESULTS: A total of 109 patients (mean age 64 years, range 19-85; 66% male, 38% never smokers) referred to our center with features suggestive of ILD underwent cTBB. The mean FVC% predicted was 77% (range 41-131), with a mean DLCO of 51% (range 20-86), and a 6-min walking test (6MWT) of 402 m (range 100-642). On average, 4 samples were taken from each patient (range 1-8), with a mean biopsy diameter of 5 mm (range 2-12). Complications included pneumothorax (11.9%), all treated with chest drain. Moderate bleeding occurred in 28.4% (all resolved without active measures). No acute disease exacerbations and no deaths occurred. A histopathological pattern diagnosis was possible in 80 cases (73.4%), and 26.6% of cases were considered nonspecific. An MDT consensus diagnosis was reached in 83.5% of cases. Subsequent SLB was proposed in 13 cases and performed in 8 cases. - CONCLUSIONS: In the real-world setting, cTBB has a meaningful diagnostic value in the context of a MDT approach and may enable histopathological assessment even in patients with more advanced disease unsuitable for SLB.