• Claudia Ravaglia, Athol U Wells, Sara Tomassetti, Alessandra Dubini, Alberto Cavazza, Sara Piciucchi, Nicola Sverzellati, Carlo Gurioli, Christian Gurioli, Ulrich Costabel, Paola Tantalocco, Jay H Ryu, Marco Chilosi, and Venerino Poletti.
• Department of Diseases of the Thorax, G.B. Morgagni - L. Pierantoni Hospital, Forlì, Italy.
• Respiration. 2017 Jan 1; 93 (4): 285-292.

BackgroundTransbronchial lung cryobiopsy is an innovative method of obtaining samples from the parenchyma of patients with diffuse parenchymal lung diseases. However, the technique is not yet standardized, and uncertainty exists about the optimal protocol, including the number of samples, the biopsy size, and the choice of the biopsy site.ObjectivesTo compare the diagnostic yield and complications of cryobiopsy with different strategies adopted to sample lung tissue (number of samples, biopsy site, and sample size).MethodsWe prospectively enrolled 46 patients with suspected diffuse parenchymal lung diseases for the diagnosis of which a biopsy was deemed useful. All patients underwent transbronchial lung cryobiopsy, and they were randomly assigned to group A (4 samples obtained from the same segment) or group B (2 samples obtained from one segment and 2 samples obtained from a different segment of the same lobe). Analysis of the samples was performed sequentially (from the first to the last sample), and pathologists reformulated their histopathologic diagnosis with the addition of each sample.ResultsThe mean diagnostic yield of the procedure combining the 2 groups and performing only the first sampling was 69%. When a second biopsy was performed as well, the mean diagnostic yield improved, but this increase was significant only when the 2 samples were obtained from 2 different segments (96%, group B).ConclusionsThis study suggests that the strategy of performing 2 biopsies with a cryoprobe may be associated with an increased diagnostic yield in diffuse parenchymal lung diseases if these samples are obtained from 2 different segments within the same lobe.© 2017 S. Karger AG, Basel.

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