Transbronchial lung cryobiopsy in smoking-related interstitial lung diseases

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Margarida Barata
Patrícia Caetano Mota
Natália Melo
Hélder Novais Bastos
Susana Guimarães
Conceição Souto Moura
José Miguel Pereira
António Morais


Transbronchial lung cryobiopsy, Smoking-related interstitial lung diseases, Diagnostic yield, Complications, Diffuse lung diseases, Surgical lung biopsy


Background: Transbronchial lung cryobiopsy (TBLC) is an emerging technique in the diagnostic approach to diffuse parenchymal lung diseases (DPLD). However, the role of TBLC in Smoking-Related Interstitial Lung Diseases (ILDs) is still under discussion.

Objectives: The aim of the present study was to describe our experience with TBLC in diagnostic work-up of patients with smoking-related ILDs.

Method: We retrospectively reviewed data of patients evaluated in a tertiary hospital ILD outpatient clinic, who underwent TBLC, from September 2014 to December 2019. TBLC was performed in accordance with the 2018 expert statement from the Cryobiopsy Working Group.

Results: Forty-two patients (23 men [54%]) with a mean age of 54.1 years [SD, 9.4] were included. The most frequent radiological pattern was ground glass opacity (39 patients). TBLC was performed in different segments of the same lobe in 36 patients and in two lobes in 6 patients. The mean maximal diameter of the samples was 5.3 mm (range, 3–16 mm [SD 2.0]). Pneumothorax occurred in six patients (14%) and moderate bleeding occurred in one patient. A specific pathological diagnosis was achieved in all cases and the most frequent was desquamative interstitial pneumonia (33 patients), followed by smoking-related interstitial fibrosis (7 patients), respiratory bronchiolitis – interstitial lung disease (1 patient) and pulmonary Langerhans cell histiocytosis (1 patient). A definitive multidisciplinary team (MDT) diagnosis was reached in 97.6% (41 of 42 cases).

Conclusions: The results from this series support TBLC as a safe procedure with a meaningful diagnostic value in the context of a MDT approach of smoking-related ILDs.


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