Open AccessTransbronchial lung biopsy: the pathologist's point of view
Author(s) -
Pourabdollah Mihan,
Shamaei Masoud,
Karimi Shirin,
Karimi Mahdi,
Kiani Arda,
Jabbari Hamid Reza
Publication year - 2016
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12207
Subject(s) - medicine , pathology , biopsy , lung , radiology
Background and Aims The efficacy of flexible cryoprobe in providing high‐quality tissue specimens through bronchoscopy for making a diagnosis remains debatable. In this study, we have compared the diagnostic yield of cryoprobe with conventional sampling by forceps. Methods Forty‐one patients scheduled to undergo transbronchial lung biopsy ( TBLB ) in a pulmonary hospital in T ehran, I ran. Each patient underwent conventional TBLB and flexible cryoprobe TBLB ( FCLB ) sequentially. Specimen adequacy was defined by the presence of at least 50 alveolar spaces or a positive diagnostic yield. Adequacy of specimens, number and percentage of alveolar spaces without artifact, type of artifact, presence of bronchiolar structures and the diagnosis made based on the results of the two methods separately were compared. Results The mean values of tissue section area obtained by forceps and cryoprobe were 6 mm 2 [standard deviation ( SD ) ± 6.7] and 22 mm 2 ( SD ± 19.1), respectively ( P < 0.001). Specimens were adequate in 26 cases of conventional TBLB and 40 cases of FCLB ( P < 0.001). Of adequate specimens, 14 samples obtained by TBLB and 28 samples obtained via FCLB were diagnostic. A significant difference was also detected between diagnostic and non‐diagnostic specimens ( P = 0.04). Frequency of specimens with >75% artifact‐free lung parenchyma was significantly higher in FCLB method. Conclusion FCLB method provides larger tissue samples with better quality compared with TBLB . Higher‐quality specimens are associated with less artifact and higher diagnostic yield. Multisite randomized trials are required to improve our knowledge about the benefits and indications of TBLB with cryoprobe.