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The evaluation of clinical usefulness of transbrochoscopic lung biopsy in undefined interstitial lung diseases: a retrospective study.

Published on Mar 1, 2017in Clinical Respiratory Journal 1.75
· DOI :10.1111/crj.12318
Qian Han3
Estimated H-index: 3
(Guangzhou Medical University),
Qun Luo4
Estimated H-index: 4
(Guangzhou Medical University)
+ 3 AuthorsRongchang Chen14
Estimated H-index: 14
(Guangzhou Medical University)
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Abstract
Background and Aims Previous studies mostly focused on the diagnostic accuracy of transbronchoscopic lung biopsy (TBLB) in the diagnosis of interstitial lung diseases (ILDs). We aimed to explore the clinical usefulness of TBLB results in the diagnostic procedure of undefined ILDs. Methods The retrospective analysis included patients undergoing TBLB for the diagnosis of undefined ILDs from January 2007 to December 2010. The clinically useful TBLB was defined as that lead to a specific histopathological diagnosis or that was consistent with the working diagnosis based on existing clinical and radiological data. Results A total of 664 patients were included in the study. TBLB failed to obtain lung parenchyma in 155 cases (23.3%). TBLB was considered clinically helpful in 202 procedures (30.4%), including 114 cases that provided definitive histopathological diagnoses and 88 cases that were consistent with working diagnoses. Among 202 cases of clinically useful TBLBs, the majority were diagnosed as pulmonary alveolar proteinosis (PAP) (67 cases, 33.2%), connective tissue disease-related ILDs (CTD-ILDs) (65, 32.2%) and idiopathic pulmonary fibrosis (IPF) (33, 16.3%). Although TBLB could provide definitive histopathological diagnoses in all cases diagnosed as PAP, only few cases of IPF (7, 21.2% of IPF diagnoses) and CTD-ILDs (9, 13.8% of CTD-ILD diagnoses) could be identified by TBLBs. Conclusion The clinical usefulness of TBLB, in conjunction with thorough clinical and radiological data, in the diagnosis of ILDs may be varied depending on different subtypes. The use of histopathological analysis and the type of biopsy employed should therefore be considered on a case-by-case basis.
  • References (32)
  • Citations (3)
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References32
Newest
Published on May 14, 2015in The American review of respiratory disease
Christopher P. Wall2
Estimated H-index: 2
,
Edward A. Gaensler33
Estimated H-index: 33
+ 1 AuthorsJ. A. Hayes14
Estimated H-index: 14
To ascertain the diagnostic reliability of transbronchial biopsy (TBB) a prospective comparison with open lung biopsy was made. All patients with undiagnosed diffuse infiltrative (interstitial) lung disease had a TBB. When this was characteristic of tumor, sarcoidosis, or infection, no additional biopsy was deemed necessary. In all other patients, an open biopsy was performed. Between January 1976 and May 1980, among 176 patients with interstitial disease, 60 (34.1%) required lung biopsy. Transb...
149 Citations Source Cite
William D. Travis1
Estimated H-index: 1
(WIMR: Woolcock Institute of Medical Research),
Ulrich Costabel59
Estimated H-index: 59
(University of Otago)
+ 33 AuthorsAthol U. Wells81
Estimated H-index: 81
(University of Newcastle)
Background: In 2002 the American Thoracic Society/European Respiratory Society (ATS/ERS) classification of idiopathic interstitial pneumonias (IIPs) defined seven specific entities, and provided standardized terminology and diagnostic criteria. In addition, the historical “gold standard” of histologic diagnosis was replaced by a multidisciplinary approach. Since 2002 many publications have provided new information about IIPs.Purpose: The objective of this statement is to update the 2002 ATS/ERS ...
1,058 Citations Source Cite
Published on Apr 26, 2013in Journal of Thoracic Disease 2.03
Qun Luo4
Estimated H-index: 4
,
Qian Han3
Estimated H-index: 3
+ 3 AuthorsRongchang Chen14
Estimated H-index: 14
Objectives: To evaluate the efficacy and safety of lung biopsies by video-assisted thoracoscopy surgery (VATS) in the diagnosis of undefined interstitial lung disease (ILD). Patients and methods: The retrospective analysis was performed in 32 who patients underwent VATS for the diagnosed with ILD from Jan 2007 to Dec 2011. The main reason for VATS for all the patients was due to no specific diagnosis could be obtained after non-invasive methods, transbronchial lung biopsy (TBLB) examination and ...
15 Citations Source Cite
Ritu Kulshrestha2
Estimated H-index: 2
,
Balakrishnan Menon5
Estimated H-index: 5
+ 1 AuthorsV.K. Vijayan2
Estimated H-index: 2
Background. Transbronchial lung biopsy (TBLB) is commonly performed for confirming the tissue diagnosis of diffuse parenchymal lung diseases (DPLDs). There is an urgent need to establish guidelines for interpretation of TBLB in order to improve its diagnostic utility. Methods. We retrospectively studied 916 consecutive patients (494 males; mean age 49 years) who underwent TBLB over a 5-year period (July 2005 to July 2010) at Vallabhbhai Patel Chest Institute. Results. In 615 (67.1%) procedures, ...
3 Citations
Published on Jul 1, 2011in Respiratory Care 1.74
Ajmal Khan11
Estimated H-index: 11
,
Ritesh Agarwal Dm37
Estimated H-index: 37
Pulmonary alveolar proteinosis is a rare but potentially treatable disease, characterized by impaired surfactant metabolism that leads to accumulation in the alveoli of proteinaceous material rich in surfactant protein and its component. Novel insights from an animal model aided the discovery of granulocyte macrophage colony stimulating factor (GM-CSF) antibodies as a pathogenetic mechanism in human pulmonary alveolar proteinosis. The vast majority of pulmonary alveolar proteinosis occurs as an ...
33 Citations Source Cite
Ganesh Raghu69
Estimated H-index: 69
,
Harold R. Collard60
Estimated H-index: 60
+ 30 AuthorsJoseph A. Lasky27
Estimated H-index: 27
This document is an international evidence-based guideline on the diagnosis and management of idiopathic pulmonary fibrosis, and is a collaborative effort of the American Thoracic Society, the European Respiratory Society, the Japanese Respiratory Society, and the Latin American Thoracic Association. It represents the current state of knowledge regarding idiopathic pulmonary fibrosis (IPF), and contains sections on definition and epidemiology, risk factors, diagnosis, natural history, staging an...
3,089 Citations Source Cite
Published on Sep 1, 2008in Thorax 9.64
Athol U. Wells81
Estimated H-index: 81
(Edin.: University of Edinburgh),
Nikhil Hirani2
Estimated H-index: 2
(Edin.: University of Edinburgh)
### 1.1 An overview of the ILD guideline Since the publication of the first BTS guidelines for diffuse lung disease nearly 10 years ago,1 the specialty has seen considerable change. The early discussions of the Guideline Group centred upon whether the revised document might consist of the 1999 document with minor adaptations. However, it was considered that too much change had taken place in the intervening years to justify a simple editorial approach. The last decade had seen the development of...
426 Citations Source Cite
Published on Jul 1, 2007in Chest 9.66
Joseph G. Parambil11
Estimated H-index: 11
(Mayo Clinic),
Jeffrey L. Myers61
Estimated H-index: 61
(UM: University of Michigan)
+ 1 AuthorsJay H. Ryu73
Estimated H-index: 73
(Mayo Clinic)
Background: Diffuse alveolar damage (DAD) is a relatively common histopathologic finding at autopsy, particularly in patients dying with ARDS, and can result from a variety of causes. The spectrum of causes and associated prognostic implications for DAD diagnosed by surgical lung biopsy are unclear. Methods: We identified 58 consecutive patients with DAD diagnosed by surgical lung biopsy over a 7-year period, January 1996 through December 2002. The presenting clinicoradiologic features, causes, ...
85 Citations Source Cite
Published on May 1, 2007in European Respiratory Journal 11.81
R. MacJannette1
Estimated H-index: 1
,
J. Fiddes1
Estimated H-index: 1
+ 1 AuthorsO. Dempsey1
Estimated H-index: 1
To the Editors: We enjoyed reading the recent retrospective analysis by Ensminger and Prakash 1 of fluoroscopy-guided bronchoscopic lung biopsies (BLB) in patients with suspected diffuse lung disease, which concluded that BLB is a clinically useful test in ∼75% of procedures. One of the most common indicators for BLB is suspected pulmonary sarcoidosis. In these patients, endobronchial biopsies (EBB) of visible mucosa, in addition to BLB, can be helpful in achieving a …
3 Citations Source Cite
Published on Mar 1, 2007in The Annals of Thoracic Surgery 3.92
Mary Elizabeth Kreider10
Estimated H-index: 10
(UPenn: University of Pennsylvania),
John Hansen-Flaschen33
Estimated H-index: 33
(UPenn: University of Pennsylvania)
+ 4 AuthorsJoseph B. Shrager42
Estimated H-index: 42
(UPenn: University of Pennsylvania)
Background Current guidelines recommend surgical lung biopsy for diagnosis of interstitial lung diseases (ILDs) in selected patients. To shed light on the risk–benefit ratio for this recommendation, we examined the morbidity and mortality associated with video-assisted thoracoscopic surgical (VATS) lung biopsy in a group of outpatients. Methods A retrospective cohort study was conducted of 68 consecutive ambulatory patients with radiographically apparent interstitial lung disease (ILD) referred ...
131 Citations Source Cite
Cited By3
Newest
Ganesh Raghu69
Estimated H-index: 69
,
Martine Remy-Jardin60
Estimated H-index: 60
+ 31 AuthorsFerran Morell36
Estimated H-index: 36
Background: This document provides clinical recommendations for the diagnosis of idiopathic pulmonary fibrosis (IPF). It represents a collaborative effort between the American Thoracic Society, Eur...
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Published on Nov 1, 2017in American Journal of Men's Health
Anthony M. Szema12
Estimated H-index: 12
(SBU: Stony Brook University),
Niely Mirsaidi1
Estimated H-index: 1
(SBU: Stony Brook University)
+ 8 AuthorsPreston Kim1
Estimated H-index: 1
High rates of respiratory symptoms (14%) and new-onset asthma in previously healthy soldiers (6.6%) have been reported among military personnel post-deployment to Iraq and Afghanistan. The term Iraq/Afghanistan War-Lung Injury (IAW-LI) is used to describe the constellation of respiratory diseases related to hazards of war, such as exposure to burning trash in burn pits, improvised explosive devices, and sandstorms. Burnpits360.org is a nonprofit civilian website which voluntarily tracks medical ...
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Published on Mar 4, 2017in Expert Opinion on Biological Therapy 3.58
Juan Chen4
Estimated H-index: 4
,
Shuhong Chi2
Estimated H-index: 2
+ 3 AuthorsXiaoming Liu14
Estimated H-index: 14
ABSTRACTIntroduction: Interstitial lung disease (ILD) is a common, devastating pulmonary complication. An increased number of reports suggesting that biological disease modifying antirheumatic drugs (DMARDs) induced or exacerbated ILDs in rheumatoid arthritis (RA) patients has garnered increased attention.Areas covered: This article discusses ILDs induced by or exacerbated during biological therapy in RA patients. The article summarizes the efficacy and safety of a variety of licensed and off-la...
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