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 2.21
· 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 Chen3
Estimated H-index: 3
(Guangzhou Medical University)
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
Ritu Kulshrestha2
Estimated H-index: 2
,
Balakrishnan Menon4
Estimated H-index: 4
+ 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 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...
148 Citations Source Cite
Published on Mar 1, 2002in Sarcoidosis Vasculitis and Diffuse Lung Diseases 1.27
Andrew G. Nicholson83
Estimated H-index: 83
,
Thomas V. Colby97
Estimated H-index: 97
,
Athol U. Wells81
Estimated H-index: 81
Abstract It is well established that some patients with connective tissue disorders will suffer from pulmonary disease at some stage in their disease progression. This article concentrates on the interstitial pneumonias, seen in association with most types of connective tissue disorder, particularly in the ligh of non-specific interstitial pneumonia (NSIP) being recognised as a distinct histological pattern. Most published articles on this subject precede recognition of NSIP and, as such, the re...
50 Citations
Published on Dec 1, 2006in European Respiratory Journal 12.24
S. A. Ensminger1
Estimated H-index: 1
(Mayo Clinic),
U.B.S. Prakash3
Estimated H-index: 3
(Mayo Clinic)
Few studies have evaluated how the results of bronchoscopic lung biopsy (BLB) affect clinical management. The objective of the present 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 2-yr period. Patients whose biopsy was of a lung mass or single dominant lung nodule were excluded. The usefulness of BLB was assessed to determin...
25 Citations Source Cite
Published on Mar 1, 2007in The Annals of Thoracic Surgery 3.78
Mary Elizabeth Kreider9
Estimated H-index: 9
(University of Pennsylvania),
John Hansen-Flaschen32
Estimated H-index: 32
(University of Pennsylvania)
+ 4 AuthorsJoseph B. Shrager42
Estimated H-index: 42
(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 ...
130 Citations Source Cite
Published on Nov 1, 1998in Chest 7.65
Lawrence S. Goldstein6
Estimated H-index: 6
(Cleveland Clinic),
Mani S. Kavuru41
Estimated H-index: 41
(Cleveland Clinic)
+ 3 AuthorsJames K. Stoller50
Estimated H-index: 50
(Cleveland Clinic)
Introduction Pulmonary alveolar proteinosis (PAP) is a rare disease of unknown etiology and variable natural history. To date, the largest series from a single institution has consisted of 68 individuals. To extend the understanding of the clinical features and natural history of PAP, we present a series of 24 patients with PAP from a single institution. Methods Patients with PAP were identified by a review of The Cleveland Clinic Foundation discharge database from 1965 to 1995. After identifica...
113 Citations Source Cite
Published on Mar 1, 2001in Arthritis & Rheumatism 7.87
Lilian Scussel Lonzetti2
Estimated H-index: 2
(Université de Montréal),
Jean-Pierre Raynauld30
Estimated H-index: 30
(Université de Montréal)
+ 5 AuthorsJean-Luc Senécal30
Estimated H-index: 30
(Université de Montréal)
174 Citations Source Cite
Published on Nov 1, 2003in Current Opinion in Rheumatology 4.28
Panagiota Latsi6
Estimated H-index: 6
,
Athol U. Wells81
Estimated H-index: 81
Purpose of review In the fibrosing alveolitis of systemic sclerosis, treatment decisions depend on prognostic evaluation, which continues to excite considerable interest and debate. Advances in the staging of fibrosing alveolitis of systemic sclerosis and recent therapeutic studies are discussed in this review. Recent findings The decision about whether to start treatment is often the most difficult clinical challenge, because many patients have limited pulmonary fibrosis that will not necessari...
88 Citations Source Cite
Published on May 1, 2006in Chest 7.65
Ema Berbescu2
Estimated H-index: 2
(State University of New York Upstate Medical University),
Anna-Luise A. Katzenstein28
Estimated H-index: 28
(State University of New York Upstate Medical University)
+ 1 AuthorsDavid A. Zisman25
Estimated H-index: 25
(University of California, Los Angeles)
Background Usual interstitial pneumonia (UIP) is a slowly progressive, usually fatal form of idiopathic interstitial pneumonia for which there is no effective treatment. Transbronchial biopsy (TBB) has been utilized only to exclude other diseases such as sarcoidosis, lymphangitic carcinoma, and infection, for example, but TBB is generally considered to have little role in confirming UIP. Objective To determine whether diagnostic changes of UIP can be appreciated on TBB specimens. Design Retrospe...
100 Citations Source Cite
  • References (32)
  • Citations (3)
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Cited By3
Published on Nov 1, 2017in American Journal of Men's Health
Anthony M. Szema12
Estimated H-index: 12
(Stony Brook University),
Niely Mirsaidi1
Estimated H-index: 1
(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 ...
2 Citations Source Cite
Published on Mar 4, 2017in Expert Opinion on Biological Therapy 3.97
Juan Chen4
Estimated H-index: 4
,
Shuhong Chi2
Estimated H-index: 2
+ 3 AuthorsXiaoming Liu13
Estimated H-index: 13
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...
2 Citations Source Cite
Ganesh Raghu66
Estimated H-index: 66
,
Martine Remy-Jardin58
Estimated H-index: 58
+ 31 AuthorsFerran Morell34
Estimated H-index: 34
Background: This document provides clinical recommendations for the diagnosis of idiopathic pulmonary fibrosis (IPF). It represents a collaborative effort between the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society.Methods: The evidence syntheses were discussed and recommendations formulated by a multidisciplinary committee of IPF experts. The evidence was appraised and recommendations were formulated, written, and graded...
57 Citations Source Cite
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