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Published in: BMC Pulmonary Medicine 1/2014

Open Access 01-12-2014 | Research article

Diagnostic yield of transbronchial cryobiopsy in non-neoplastic lung disease: a retrospective case series

Authors: Sergej Griff, Nicolas Schönfeld, Wilhelm Ammenwerth, Torsten-Gerriet Blum, Christian Grah, Torsten T Bauer, Wolfram Grüning, Thomas Mairinger, Henrik Wurps

Published in: BMC Pulmonary Medicine | Issue 1/2014

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Abstract

Background

Due to the small amount of alveolar tissue in transbronchial biopsy (TBB) by forceps, the diagnosis of diffuse, parenchymal lung diseases (DPLD) is inherently problematic, with an overall low yield. The use of cryotechnique in bronchoscopy, including TBB by cryoprobe, has revealed new opportunities in the endoscopical diagnosis of malignant and non-malignant lung diseases.

Methods

To evaluate TBB by cryotechnique for non-neoplastic lung diseases, we analyzed 52 patients (mean age 63 ± 13 years) with unclear DPLD. These individuals underwent bronchoscopy with TBB by cryoprobe. Thereafter histopathological results were compared with the clinically evaluated diagnosis.

Results

No major complications were seen. Mean specimen diameter in the histological biopsies was 6.9 ± 4.4 mm (Range 2 – 22 mm). A correlation between clinical and histopathological diagnoses was found in 79% of cases (41/52). In the case of UIP (usual interstitial pneumonia) pattern, the concordance was 10/15 (66%).

Conclusion

Based on these results TBB by cryotechnique would appear to be a safe and useful method that reveals new perspectives for the endoscopical diagnosis of DPLD.
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Literature
1.
go back to reference Berbescu EA, Katzenstein AL, Snow JL, Zisman DA: Transbronchial biopsy in usual interstitial pneumonia. Chest. 2006, 129 (5): 1126-1131. 10.1378/chest.129.5.1126.CrossRefPubMedPubMedCentral Berbescu EA, Katzenstein AL, Snow JL, Zisman DA: Transbronchial biopsy in usual interstitial pneumonia. Chest. 2006, 129 (5): 1126-1131. 10.1378/chest.129.5.1126.CrossRefPubMedPubMedCentral
2.
go back to reference Katzenstein AL, Askin FB: Interpetation and significance of pathologic findings in transbronchial lung biopsy. Am J Surg Pathol. 1980, 4 (3): 223-234. 10.1097/00000478-198006000-00002.CrossRefPubMed Katzenstein AL, Askin FB: Interpetation and significance of pathologic findings in transbronchial lung biopsy. Am J Surg Pathol. 1980, 4 (3): 223-234. 10.1097/00000478-198006000-00002.CrossRefPubMed
3.
go back to reference Joyner LR, Scheinhorn DJ: Transbronchial forceps lung biopsy through the fiberotic bronchoscope, diagnosis of diffuse pulmonary disease. Chest. 1975, 67: 532-535. 10.1378/chest.67.5.532.CrossRefPubMed Joyner LR, Scheinhorn DJ: Transbronchial forceps lung biopsy through the fiberotic bronchoscope, diagnosis of diffuse pulmonary disease. Chest. 1975, 67: 532-535. 10.1378/chest.67.5.532.CrossRefPubMed
4.
go back to reference Katzenstein AL: Katzenstein and Askin’s Surgical Pathology of Non-Neoplastic Lung Disease. 2006, Philadelphia, USA: Saunders Company, 4 Katzenstein AL: Katzenstein and Askin’s Surgical Pathology of Non-Neoplastic Lung Disease. 2006, Philadelphia, USA: Saunders Company, 4
5.
go back to reference Zavala DC: Diagnostic fiberoptic bronchoscopy, techniques and results of biopsy in 600 patients. Chest. 1975, 68: 12-19.CrossRefPubMed Zavala DC: Diagnostic fiberoptic bronchoscopy, techniques and results of biopsy in 600 patients. Chest. 1975, 68: 12-19.CrossRefPubMed
6.
go back to reference Fraire AE, Cooper SP, Greenberg SD, Rowland LP, Langston C: Transbronchial lung biopsy: histopathologic and morphometric assessment of diagnostic utility. Chest. 1992, 102: 748-752. 10.1378/chest.102.3.748.CrossRefPubMed Fraire AE, Cooper SP, Greenberg SD, Rowland LP, Langston C: Transbronchial lung biopsy: histopathologic and morphometric assessment of diagnostic utility. Chest. 1992, 102: 748-752. 10.1378/chest.102.3.748.CrossRefPubMed
7.
go back to reference Payne CR, Hadfield JW, Stovin PG, Barker V, Heard BE, Stark JE: Diagnostic accuracy of cytology and biopsy in primary bronchial carcinoma. J Clin Pathol. 1981, 34: 773-778. 10.1136/jcp.34.7.773.CrossRefPubMedPubMedCentral Payne CR, Hadfield JW, Stovin PG, Barker V, Heard BE, Stark JE: Diagnostic accuracy of cytology and biopsy in primary bronchial carcinoma. J Clin Pathol. 1981, 34: 773-778. 10.1136/jcp.34.7.773.CrossRefPubMedPubMedCentral
8.
go back to reference Rudd RM, Gellert AR, Boldy DAR, Studdy PR, Pearson MC, Geddes DM, Sinha G: Bronchoscopic and percutaneus aspiration biopsy in the diagnosis of brochial cell type. Thorax. 1982, 37: 462-465. 10.1136/thx.37.6.462.CrossRefPubMedPubMedCentral Rudd RM, Gellert AR, Boldy DAR, Studdy PR, Pearson MC, Geddes DM, Sinha G: Bronchoscopic and percutaneus aspiration biopsy in the diagnosis of brochial cell type. Thorax. 1982, 37: 462-465. 10.1136/thx.37.6.462.CrossRefPubMedPubMedCentral
9.
go back to reference Franke KJ, Nilius G, Rühle KH: Bronchocopic diagnosis of peripheral pulmonary foci. Dtsch Med Wochenschr. 2006, 131: 2229-2233. 10.1055/s-2006-951358.CrossRefPubMed Franke KJ, Nilius G, Rühle KH: Bronchocopic diagnosis of peripheral pulmonary foci. Dtsch Med Wochenschr. 2006, 131: 2229-2233. 10.1055/s-2006-951358.CrossRefPubMed
10.
go back to reference Descombes E, Gardiol D, Leuenberger P: Transbronchial lung biopsy: an analysis of 530 cases with reference to the number of samples. Monaldi Arch Chest Dis. 1997, 52 (4): 324-329.PubMed Descombes E, Gardiol D, Leuenberger P: Transbronchial lung biopsy: an analysis of 530 cases with reference to the number of samples. Monaldi Arch Chest Dis. 1997, 52 (4): 324-329.PubMed
11.
go back to reference Baaklini WA, Reinoso MA, Gorin AB, Sharafkaneh A, Manian P: Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest. 2000, 117: 1049-1054. 10.1378/chest.117.4.1049.CrossRefPubMed Baaklini WA, Reinoso MA, Gorin AB, Sharafkaneh A, Manian P: Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest. 2000, 117: 1049-1054. 10.1378/chest.117.4.1049.CrossRefPubMed
12.
go back to reference Schönfeld N, Frank W, Wenig S, Uhrmeister P, Allica E, Preussler H, Grassot A, Loddenkemper R: Clinical and radiologic features, lung function and therapeutic results in pulmonary histiocytosis X. Respiration. 1993, 60 (1): 38-44.CrossRefPubMed Schönfeld N, Frank W, Wenig S, Uhrmeister P, Allica E, Preussler H, Grassot A, Loddenkemper R: Clinical and radiologic features, lung function and therapeutic results in pulmonary histiocytosis X. Respiration. 1993, 60 (1): 38-44.CrossRefPubMed
13.
go back to reference Ryu JH, Myers JL, Capizzi SA, Duoglas WW, Vassallo R, Decker PA: Desquamative interstitial pneumonia and respiratory bronchiolitis-associated interstitial lung disease. Chest. 2005, 127: 178-184. 10.1378/chest.127.1.178.CrossRefPubMed Ryu JH, Myers JL, Capizzi SA, Duoglas WW, Vassallo R, Decker PA: Desquamative interstitial pneumonia and respiratory bronchiolitis-associated interstitial lung disease. Chest. 2005, 127: 178-184. 10.1378/chest.127.1.178.CrossRefPubMed
14.
go back to reference Casoni GL, Gurioli C, Chhajed PN, Chilosi M, Zompatori M, Olivieri D, Poletti V: The value of transbronchial lung biopsy using jumbo forceps via rigid bronchoscope in diffuse lung disease. Monaldi Arch Chest Dis. 2008, 69 (2): 59-64.PubMed Casoni GL, Gurioli C, Chhajed PN, Chilosi M, Zompatori M, Olivieri D, Poletti V: The value of transbronchial lung biopsy using jumbo forceps via rigid bronchoscope in diffuse lung disease. Monaldi Arch Chest Dis. 2008, 69 (2): 59-64.PubMed
15.
go back to reference Oliveira CC, Fabro AT, Ribeiro SM, Defaveri J, Capelozzi VL, Queluz THT, Yoo HHB: Evaluation of the use of transbronchial biopsy in patients with clinical suspicion of interstitial lung disease. J Bras Pneumol. 2011, 37 (2): 168-175.PubMed Oliveira CC, Fabro AT, Ribeiro SM, Defaveri J, Capelozzi VL, Queluz THT, Yoo HHB: Evaluation of the use of transbronchial biopsy in patients with clinical suspicion of interstitial lung disease. J Bras Pneumol. 2011, 37 (2): 168-175.PubMed
16.
go back to reference Romagnoli M, Bigliazzi C, Casoni G, Chilosi M, Carloni A, Dubini A, Gurioli C, Tomassetti S: The role of transbronchial lung biopsy for the diagnosis of diffuse drug-induced lung disease: a case series of 44 patients. Sarcoidosis Vasc Diffuse Lung Dis. 2008, 25 (1): 36-45.PubMed Romagnoli M, Bigliazzi C, Casoni G, Chilosi M, Carloni A, Dubini A, Gurioli C, Tomassetti S: The role of transbronchial lung biopsy for the diagnosis of diffuse drug-induced lung disease: a case series of 44 patients. Sarcoidosis Vasc Diffuse Lung Dis. 2008, 25 (1): 36-45.PubMed
17.
go back to reference Shim HS, Park MS, Park IK: Histopathologic findings of transbronchial biopsy in usual interstitial pneumonia. Pathol Int. 2010, 60 (5): 373-377. 10.1111/j.1440-1827.2010.02528.x.CrossRefPubMed Shim HS, Park MS, Park IK: Histopathologic findings of transbronchial biopsy in usual interstitial pneumonia. Pathol Int. 2010, 60 (5): 373-377. 10.1111/j.1440-1827.2010.02528.x.CrossRefPubMed
18.
go back to reference Franke KJ, Theegarten D, Hann von Weyhern C, Nilius G, Brueckner C, Hetzel J, Hetzel M, Ruhle KH, Enderle MD, Szyrach MN: Prospective controlled animal study on biopsy sampling with new flexible cryoprobes versus forceps: evaluation of biopsy size, histological quality and bleeding risk. Respiration. 2010, 80 (2): 127-132. 10.1159/000287251.CrossRefPubMed Franke KJ, Theegarten D, Hann von Weyhern C, Nilius G, Brueckner C, Hetzel J, Hetzel M, Ruhle KH, Enderle MD, Szyrach MN: Prospective controlled animal study on biopsy sampling with new flexible cryoprobes versus forceps: evaluation of biopsy size, histological quality and bleeding risk. Respiration. 2010, 80 (2): 127-132. 10.1159/000287251.CrossRefPubMed
19.
go back to reference Schumann C, Hetzel J, Babiak AJ, Merk T, Wibmer T, Möller P, Lepper PM, Hetzel M: Cryoprobe biopsy increases the diagnostic yield in endobronchial tumor lesions. J Thorac Cardiovasc Surg. 2010, 140 (2): 417-421. 10.1016/j.jtcvs.2009.12.028.CrossRefPubMed Schumann C, Hetzel J, Babiak AJ, Merk T, Wibmer T, Möller P, Lepper PM, Hetzel M: Cryoprobe biopsy increases the diagnostic yield in endobronchial tumor lesions. J Thorac Cardiovasc Surg. 2010, 140 (2): 417-421. 10.1016/j.jtcvs.2009.12.028.CrossRefPubMed
20.
go back to reference Griff S, Ammenwerth W, Schönfeld N, Bauer TT, Mairinger R, Blum T, Kollmeier J, Grüning W: Morphometrical analysis of transbronchial cryobiopsies. Diagn Pathol. 2011, 6: 53-10.1186/1746-1596-6-53.CrossRefPubMedPubMedCentral Griff S, Ammenwerth W, Schönfeld N, Bauer TT, Mairinger R, Blum T, Kollmeier J, Grüning W: Morphometrical analysis of transbronchial cryobiopsies. Diagn Pathol. 2011, 6: 53-10.1186/1746-1596-6-53.CrossRefPubMedPubMedCentral
21.
go back to reference Aktas Z, Gunay E, Hoca NT, Yilmaz A, Demirag F, Gunay S, Sipit T, Kurt EB: Endobronchial cryobiopsy or forceps biopsy for lung cancer diagnosis. Ann Thorac Med. 2010, 5 (4): 242-246. 10.4103/1817-1737.69117.CrossRefPubMedPubMedCentral Aktas Z, Gunay E, Hoca NT, Yilmaz A, Demirag F, Gunay S, Sipit T, Kurt EB: Endobronchial cryobiopsy or forceps biopsy for lung cancer diagnosis. Ann Thorac Med. 2010, 5 (4): 242-246. 10.4103/1817-1737.69117.CrossRefPubMedPubMedCentral
22.
go back to reference Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, Colby TV, Cordier JF, Flaherty KR, Lasky JA, Lynch DA, Ryu JH, Swigris JJ, Wells AU, Ancochea J, Bouros D, Carvalho D, Costabel U, Ebina M, Hansell DM, Johkoh T, Kim DS, King TE, Kondoh Y, Myers J, Mü̈ller NL, Nicholson AG, Richeldi L, Selman M, Dudden RF, et al: An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011, 183: 794-CrossRef Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, Colby TV, Cordier JF, Flaherty KR, Lasky JA, Lynch DA, Ryu JH, Swigris JJ, Wells AU, Ancochea J, Bouros D, Carvalho D, Costabel U, Ebina M, Hansell DM, Johkoh T, Kim DS, King TE, Kondoh Y, Myers J, Mü̈ller NL, Nicholson AG, Richeldi L, Selman M, Dudden RF, et al: An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011, 183: 794-CrossRef
23.
go back to reference American Thoracic Society/European Respiratory Society: International multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2002, 165: 277-304.CrossRef American Thoracic Society/European Respiratory Society: International multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2002, 165: 277-304.CrossRef
24.
go back to reference Silva CI, Müller NL, Lynch DA, Curran-Everett D, Brown KK, Lee KS, Chung MP, Churg A: Chronic hypersensitivity pneumonitis: differentiation from idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia by using thin-section CT. Radiology. 2008, 246 (1): 288-297. 10.1148/radiol.2453061881.CrossRefPubMed Silva CI, Müller NL, Lynch DA, Curran-Everett D, Brown KK, Lee KS, Chung MP, Churg A: Chronic hypersensitivity pneumonitis: differentiation from idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia by using thin-section CT. Radiology. 2008, 246 (1): 288-297. 10.1148/radiol.2453061881.CrossRefPubMed
25.
go back to reference Takemura T, Akashi T, Kamiya H, Ikushima S, Ando T, Oritsu M, Sawahata M, Ogura T: Pathological differentiation of chronic hypersensitivity pneumonitis from idiopathic pulmonary fibrosis/usual interstitial pneumonia. Histopathology. 2012, 61 (6): 1026-1035. 10.1111/j.1365-2559.2012.04322.x.CrossRefPubMed Takemura T, Akashi T, Kamiya H, Ikushima S, Ando T, Oritsu M, Sawahata M, Ogura T: Pathological differentiation of chronic hypersensitivity pneumonitis from idiopathic pulmonary fibrosis/usual interstitial pneumonia. Histopathology. 2012, 61 (6): 1026-1035. 10.1111/j.1365-2559.2012.04322.x.CrossRefPubMed
26.
go back to reference Dina R, Sheppard MN: The histological diagnosis of clinically documented cases of cryptogenic organizing pneumonia: diagnostic features in transbronchial biopsies. Histopathology. 1993, 23 (6): 541-545. 10.1111/j.1365-2559.1993.tb01240.x.CrossRefPubMed Dina R, Sheppard MN: The histological diagnosis of clinically documented cases of cryptogenic organizing pneumonia: diagnostic features in transbronchial biopsies. Histopathology. 1993, 23 (6): 541-545. 10.1111/j.1365-2559.1993.tb01240.x.CrossRefPubMed
27.
go back to reference Jareno Esteban J, Zamora Garcia E, Chillon Martin MJ, Pérez Amor E, Villegas Fernández F, Forniés Menéndez E, Callol Sánchez L: Bronchiolitis obliterans with organizing pneumonia, usefulness and yield of diagnostic techniques and procedures in a series of 20 patients. An Med Interna. 2001, 18 (2): 63-68.PubMed Jareno Esteban J, Zamora Garcia E, Chillon Martin MJ, Pérez Amor E, Villegas Fernández F, Forniés Menéndez E, Callol Sánchez L: Bronchiolitis obliterans with organizing pneumonia, usefulness and yield of diagnostic techniques and procedures in a series of 20 patients. An Med Interna. 2001, 18 (2): 63-68.PubMed
28.
go back to reference Gerasin VA, Molodtsova VP, Dvorakovskaia IV, Derevianko AV, Bazhanov AA, Baranova OP: Transbronchial biopsy of the lungs in diagnosis of respiratory sarcoidosis. Ter Arkh. 2008, 80 (4): 43-46.PubMed Gerasin VA, Molodtsova VP, Dvorakovskaia IV, Derevianko AV, Bazhanov AA, Baranova OP: Transbronchial biopsy of the lungs in diagnosis of respiratory sarcoidosis. Ter Arkh. 2008, 80 (4): 43-46.PubMed
29.
go back to reference Cucevic I, Cucevic B, Pongrac I, Roglic M: Comparative analysis of bronchoalveolar lavage and transbronchial lung biopsy in pulmonary sarcoidosis. Plucne Bolesti. 1991, 43 (1–2): 106-108.PubMed Cucevic I, Cucevic B, Pongrac I, Roglic M: Comparative analysis of bronchoalveolar lavage and transbronchial lung biopsy in pulmonary sarcoidosis. Plucne Bolesti. 1991, 43 (1–2): 106-108.PubMed
Metadata
Title
Diagnostic yield of transbronchial cryobiopsy in non-neoplastic lung disease: a retrospective case series
Authors
Sergej Griff
Nicolas Schönfeld
Wilhelm Ammenwerth
Torsten-Gerriet Blum
Christian Grah
Torsten T Bauer
Wolfram Grüning
Thomas Mairinger
Henrik Wurps
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2014
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-14-171

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