Diagnostic Yield of Transbronchial Lung Cryobiopsy Compared to Transbronchial Forceps Biopsy in Patients with Sarcoidosis in a Prospective, Randomized, Multicentre Cross-Over Trial

Journal of Clinical Medicine

Michael Kreuter¹  Lars Hagmeyer²  Wolfgang Gesierich³  Henry C. Evrard⁴  Christoph Petermann⁵  Kaid Darwiche⁶  Ahmed Ehab⁷  Werner Spengler⁷  Michael Böckeler⁷  Jürgen Hetzel⁷  Maik Häntschel⁷  Annika Felicitas Behrens-Zemek⁷  Thomas V. Colby⁸  Ralf Eberhardt⁹  Hanns-Olof Wintzer^1,10  Falko Fend^1,11  Dirk Theegarten^1,12  Richard A. Lewis^1,13 

[1] Center for Interstitial and Rare Lung Diseases, Department of Pneumology, Thoraxklinik, University of Heidelberg and German Center for Lung Research (DZL), 69117 Heidelberg, Germany;Clinic for Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital, 42699 Solingen, Germany;Comprehensive Pneumology Center Munich, Asklepios-Fachkliniken Munich-Gauting, 81377 Munich, Germany;Department Physiology of Cognitive Processes, Max Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany;Department for Pulmonary Diseases, Asklepios-Klinik Hamburg, 22307 Hamburg, Germany;Department of Interventional Pneumology, Ruhrlandklinik—University Medicine Essen, University of Duisburg-Essen, 47057 Duisburg, Germany;Department of Medical Oncology and Pneumology, Eberhard Karls University of Tübingen, 72074 Tübingen, Germany;Department of Pathology (Emeritus), Mayo Clinic, Scottsdale, AZ 13400, USA;Department of Pneumology and Critical Care Medicine, Asklepios-Klinik Barmbek, 22307 Hamburg, Germany;Institute for Pathology, MVZ Hanse Histologikum, 22547 Hamburg, Germany;Institute of Pathology and Neuropathology, Reference Center for Hematopathology University Hospital, Eberhard Karls University of Tübingen, 72074 Tübingen, Germany;Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, 7057 Essen, Germany;University of Worcester, Worcester WR2 6AJ, UK;

关键词: sarcoidosis;    bronchoscopy;    transbronchial biopsy;    cryobiopsy;   

DOI  :  10.3390/jcm10235686

来源: DOAJ

【 摘 要 】

Background: Transbronchial lung forceps biopsy (TBLF) is of limited value for the diagnosis of interstitial lung disease (ILD). However, in cases with predominantly peribronchial pathology, such as sarcoidosis, TBLF is considered to be diagnostic in most cases. The present study examines whether transbronchial lung cryobiopsy (TBLC) is superior to TBLF in terms of diagnostic yield in cases of sarcoidosis. Methods: In this post hoc analysis of a prospective, randomized, controlled, multicentre study, 359 patients with ILD requiring diagnostic bronchoscopic tissue sampling were included. TBLF and TBLC were both used for each patient in a randomized order. Histological assessment was undertaken on each biopsy and determined whether sarcoid was a consideration. Results: A histological diagnosis of sarcoidosis was established in 17 of 272 cases for which histopathology was available. In 6 out of 17 patients, compatible findings were seen with both TBLC and TBLF. In 10 patients, where the diagnosis of sarcoidosis was confirmed by TBLC, TBLF did not provide a diagnosis. In one patient, TBLF but not TBLC confirmed the diagnosis of sarcoidosis. Conclusions: In this post hoc analysis, the histological diagnosis of sarcoidosis was made significantly more often by TBLC than by TBLF. As in other idiopathic interstitial pneumonias (IIPs), the use of TBLC should be considered when sarcoidosis is suspected.

【 授权许可】

Unknown