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Does lung biopsy help patients with interstitial lung disease?
Rizwan A Qureshi1, Tanveer A Ahmed, Antony D Grayson
1Department of Thoracic Surgery, The Cardiothoracic Centre-Liverpool, Thomas Drive, Liverpool L14 3PE, UK.
Summary
Lung biopsy for interstitial lung disease (ILD) often yields non-specific diagnoses and may not alter treatment. Factors like biopsy site or size do not significantly predict diagnostic yield, though multiple biopsies show a trend for improvement.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Pathology
Background:
- Interstitial lung disease (ILD) diagnosis relies on lung biopsy, but its diagnostic yield varies.
- The decision to biopsy is based on the likelihood of achieving a specific diagnosis and guiding treatment.
- Identifying factors influencing biopsy yield is crucial for optimizing patient management.
Purpose of the Study:
- To determine factors influencing the diagnostic yield of lung biopsy in patients with interstitial lung disease.
- To assess the impact of biopsy characteristics on achieving a specific diagnosis and altering patient therapy.
Main Methods:
- A retrospective analysis of 100 patients with ILD who underwent lung biopsy over 5 years.
- Data collected included patient demographics, biopsy type (open vs. videothoracoscopic), site, size, number, laterality, and pre-operative therapy.
- Statistical comparison of these factors against diagnostic yield (specific vs. non-specific diagnosis) and treatment alteration.
Main Results:
- A specific diagnosis was achieved in 42% of patients; 58% had non-specific findings.
- No significant correlation was found between biopsy site, size, number, or laterality and diagnostic yield.
- Therapy alteration occurred in 59.5% of patients with specific diagnoses and 55.2% with non-specific diagnoses.
Conclusions:
- Lung biopsy for ILD does not consistently provide a specific diagnosis or lead to therapy changes.
- Biopsy specimen characteristics (site, size, number, laterality) do not definitively influence diagnostic outcomes.
- A trend suggests that performing multiple biopsies, particularly on the right lung, may improve diagnostic yield.