Is bronchoscopic lung biopsy helpful in the management of patients with diffuse lung disease?

¹ Mayo Clinic College of Medicine, Mayo Medical Center, Rochester, Minnesota, USA

^* To whom correspondence should be addressed. E-mail: prakash.udaya{at}mayo.edu.

	Abstract

Few studies have evaluated how the results of bronchoscopic lung biopsy (BLB) affect clinical management. The objective of this study was to evaluate the clinical usefulness of BLB in the overall management of patients with diffuse pulmonary diseases.

The study was a retrospective analysis of patients who underwent fluoroscopy guided BLB over a two year period. Patients whose biopsy was of a lung mass or single dominant lung nodule were excluded. The usefulness of BLB was assessed to determine if the results affected the clinical management of these patients.

During the study period, 603 patients underwent 651 BLB procedures. The results of BLB were clinically helpful in 494 of 651 procedures (75.9%). No diagnostic abnormality was identified in 107 of the 651 biopsy procedures (16.4%). This finding was clinically helpful in 59/107 (55.1%), as the results excluded specific processes suspected before BLB. In 52 procedures (8% of all BLB), no lung parenchyma was obtained.

BLB is a clinically useful test in approximately 75% of procedures. In the 25% of BLBs that were clinically unhelpful, the reason for failure in approximately 1/3 of patients was the failure of the procedure to obtain an adequate quantity of lung parenchyma for a meaningful histologic analysis.

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