Chest
Original Research: Diffuse Lung DiseaseTransbronchial Cryobiopsy in Diffuse Parenchymal Lung Disease: Retrospective Analysis of 74 Cases
Section snippets
Methods
The study was approved by the Mayo Clinic Institutional Review Board (IRB 15-008652). We conducted a retrospective review of the clinical records of patients with DPLD from June 2013 to September 2015 at the Mayo Clinic in Rochester, Minnesota. Over the period examined, 200 cryobiopsies in 187 patients were performed at our institution. The medical records were analyzed, and demographic data, chest CT scans, procedure details and complications, diagnostic results, and pathologic features were
Results
Seventy-four patients were included in the study cohort: 33 were women (45%), with a mean age of 63 years (range, 20-89 years [SD, 13.8]) (Table 1). The mean maximal diameter of samples was 9.2 mm (range, 2-20 mm [SD, 3.9]). Most of the patients (59 patients) had biopsy samples obtained from one lobe; the remaining 15 patients had biopsy samples obtained from two lobes. The median number of samples per procedure was three (range, one to seven). Histologic slides were available for review by a
Discussion
The role of TBC in DPLD evaluation is still evolving. Previous studies from multiple centers have demonstrated the feasibility of the technique,6, 7, 8, 9, 11, 12, 17, 18, 19, 20 but there is a lack of consensus on the indications, contraindications, and diagnostic accuracy. Thus, its role remains controversial.
Our study demonstrated a diagnostic yield of 51% when a positive biopsy result was defined as diagnostic histologic findings, histologic findings that supported a final diagnosis, or
Conclusions
Our single-center cohort demonstrated a 51% diagnostic yield from TBC, which was lower than that of previously published data from other centers. Nevertheless, it was considered helpful in 78% of patients when histopathologic data were integrated with clinical-radiological data in a multidisciplinary approach. Potential bleeding, pneumothorax, and delayed complications remain a concern. Optimal patient selection and the technique of TBC still need to be determined.
Acknowledgments
Author contributions: K. U. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. K. U. contributed to the conception and design; collection, analysis, and interpretation of data; drafting and critical revision of the article; and collection/generation of the images. R. M. K. contributed to the experiments, collection of the data, and critical revision of the article. A. C. R. contributed to the collection,
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FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.