Transbronchial cryobiopsy validity in diagnosing diffuse parenchymal lung diseases in Egyptian population
Received 15 March 2019
Accepted for publication 19 July 2019
Published 30 August 2019 Volume 2019:12 Pages 719—726
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Hanaa Shafiek,1 Shaimaa Elbialy,1 Samar Nabil El Achy,2 Ahmed Youssef Shaaban Gad1
1Chest Diseases Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt; 2Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Correspondence: Hanaa Shafiek
Chest Diseases Department, Faculty of Medicine, Alexandria University, El-Khartoom Square, Alexandria 21526, Egypt
Tel +20 109 590 7320
Objectives: We aimed to evaluate the efficacy, safety, and diagnostic utility of transbronchial cryobiopsy (TBCB) in diagnosing diffuse parenchymal lung diseases (DPLDs) in an Egyptian population and to identify common DPLD pathologies among them.
Methods: This prospective interventional study enrolled 25 Egyptian patients presenting to the Main Alexandria University Hospital who had clinical and radiological features of DPLD, but insufficient elements to achieve definite features of usual interstitial pneumonia on chest high-resolution computed tomography. Twelve patients were subjected to TBCB and 13 to forceps transbronchial lung biopsy (TBLB).
Results: The diagnostic yield was significantly higher among the TBCB group (83.3%), and increased to 100% with clinicopathological correlation vs the TBLB group (38.5%, P=0.041). Granulomatous diseases (24%, either sarcoidosis or hypersensitivity pneumonitis) were the commonest pathology, followed by malignancy (12%) in both groups. TBCB sizes were 2.5–5 mm vs 1-3 mm in TBLB (P<0.001), with preserved tissue architecture (91.7% vs 38.5%, respectively; P=0.011). Only 8.3% were complicated by insignificant bleeding grade 2 after TBCB, but no pneumothorax was detected.
Conclusion: TBCB is a safe, tolerable procedure with high diagnostic yield for evaluating DPLD with indefinite usual interstitial pneumonia pattern on high-resolution computed tomography.
Keywords: interstitial lung diseases, bronchoscopy and interventional techniques, pathology
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