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Transbronchial lung biopsy ( TBLB ) is uncommonly performed in non‐malignant conditions because of its low sensitivity and small tissue samples. It is not routinely performed in  A ustralia to investigate idiopathic pulmonary fibrosis, although it can be a useful adjunct in obtaining tissue diagnosis in selected conditions in interstitial lung disease ( ILD ). A 52‐year‐old non‐smoker received a living unrelated renal transplant in  J anuary 2014 but developed insidious onset of dyspnea on exertion 1 year later. Computed tomography of the thorax showed bilateral persistent ground glass opacifications with a characteristic crazy paving pattern, although   P   neumocystis jirovecii  pneumonia was more concerning. He was treated as   P   neumocystis jirovecii  pneumonia but his initial bronchoscopy failed to confirm either diagnoses. He then went on to  TBLB  that showed the presence of periodic acid–Schiff staining material. We conclude that  TBLB  is a useful adjunct to obtain histological diagnosis of  ILD  in carefully selected patients with appropriate radiological indications.

Transbronchial lung biopsy ( TBLB ) in diagnosing pulmonary alveolar proteinosis ( PAP ): forgotten role in A ustralia?