• Lung India · Sep 2015

    Transbronchial lung biopsy in patients with diffuse parenchymal lung disease without 'idiopathic pulmonary fibrosis pattern' on HRCT scan - Experience from a tertiary care center of North India.

    • Girish Sindhwani, Nadia Shirazi, Rakhee Sodhi, Shailendra Raghuvanshi, and Jagdish Rawat.
    • Department of Pulmonary Medicine, Guru Gobind Singh Medical College, Faridkot, Punjab, India.
    • Lung India. 2015 Sep 1; 32 (5): 453-6.

    BackgroundDiffuse parenchymal lung diseases (DPLD) are a group of disorders characterized by chest radiological findings of bilateral diffuse shadowing. Lung biopsy is generally required to make an etiological diagnosis of DPLD's. Transbronchial lung biopsy (TBLB) is a minimally invasive method to achieve a lung sample which has been found to be a useful diagnostic tool in patients with DPLD. As per American Thoracic Society guidelines for management of idiopathic interstitial pneumonias, TBLB is not required in patients who have findings consistent with idiopathic pulmonary fibrosis (IPF) on HRCT scan thorax. Some Indian researchers have evaluated, on a small number of subjects, the role of TBLB in patients with DPLD, but they had not excluded patients with 'IPF pattern'. This study was planned to assess TBLB in patients with DPLD after excluding patients with 'IPF pattern'.Materials And MethodsA prospective non-randomized study on 49 patients with DPLD without a characteristic 'IPF pattern' were subjected to TBLB.ResultsThe overall diagnostic yield of TBLB was 85.7%. Non-specific interstitial pneumonitis, tuberculosis and sarcoidosis were the most common histology patterns found (22.4, 18.4 and 16.3%, respectively). Procedure-related mortality was nil. Iatrogenic pneumothorax occurred in five patients (10.2%). Minor complications included hemorrhage and transient hypoxia.ConclusionTBLB is a safe and effective tool in the diagnosis of DPLD.

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