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Pulmonary Medicine
Volume 2017, Article ID 6794343, 7 pages
https://doi.org/10.1155/2017/6794343
Research Article

Role of Transbronchial Lung Cryobiopsies in Diffuse Parenchymal Lung Diseases: Interest of a Sequential Approach

1Department of Pneumology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
2Department of Pneumology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
3Department of Pneumology, AZ Glorieux, Ronse, Belgium
4Department of Thoracic Surgery, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
5Department of Pathology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
6Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium

Correspondence should be addressed to Benjamin Bondue; eb.ca.blu@eudnobb

Received 23 December 2016; Revised 23 March 2017; Accepted 2 April 2017; Published 20 April 2017

Academic Editor: Charlie Strange

Copyright © 2017 Benjamin Bondue et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Transbronchial lung cryobiopsies (TBLCs) are a promising diagnostic tool in the setting of diffuse parenchymal lung diseases (DPLDs). However, no comparison with surgical lung biopsy (SLB) in the same patient is available. Methods. The diagnostic yield and safety data of TBLCs, as well as the result of SLB performed after TBLCs, were analysed in a multicentric Belgian study. A SLB was performed after TBLCs in absence of a definite pathological diagnosis or if a NSIP pattern was observed without related condition identified following multidisciplinary discussion. Results. Between April 2015 and November 2016, 30 patients were included. Frequent complications included pneumothorax (20%) and bleeding (severe 7%, moderate 33%, and mild 53%). There was no mortality. The overall diagnostic yield was 80%. A SLB was performed in six patients (three without definite histological pattern and three with an NSIP). The surgical biopsy changed the pathological diagnosis into a UIP pattern in five patients and confirmed a NSIP pattern in one patient. Conclusion. TBLCs are useful in the diagnostic work-up of DPLDs avoiding a SLB in 80% of the patients. However, surgical biopsies, performed as a second step after TBLCs because of an indefinite diagnosis or a NSIP pattern, provide additional information supporting the interest of a sequential approach in these patients.