| dc.description | BACKGROUND: Transbronchial lung cryobiopsy (TLCB), performed with a flexible cryoprobe, is an
interventional pulmonology procedure that has proved its diagnostic value for interstitial pulmonary
disease. However, it has not been explored extensively as a diagnostic tool for patients with noninterstitial
lung pathology, including infectious and malignant diseases.
OBJECTIVE: To evaluate the diagnostic yield and safety of an interventional pulmonology approach
that integrates TLCB and bronchoalveolar lavage (BAL) for the diagnosis of non-interstitial
pulmonary disease.
METHODS: TLCB and BAL were performed under general anesthesia through the same
bronchoscopic access on 103 adult patients (including immunocompromised HIV+ individuals) with
clinical/radiological evidence of non-interstitial lung disease admitted to the Interventional
Pulmonology Service between May 2015 and April 2016. Samples obtained were sent to pathology
and microbiology laboratories for standard diagnostic analysis.
RESULTS: Samples of TLCB allowed the diagnosis of 75.7% of patients, while 39.8% were diagnosed
from BAL. The global diagnostic yield from the dual sampling was 92.2%. TLCB allowed the diagnosis
of 94.7% of cancer cases and 60.0% of infectious cases, while BAL samples identified 77.5% of
infectious cases and 21.2% of malignant lesions. The incidence of complications was 4.9% with full
recovery in all cases.
CONCLUSIONS: Simultaneous TLCB and BAL constitute a safe and useful diagnostic procedure for
non-interstitial pulmonary disease, with a global diagnostic yield of 92.2%. Complementary
advantages of samples obtained by each technique result in a robust diagnostic strategy for
infectious and malignant disease in adults, including HIV+ individuals. | |
