[Videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease]

Video-assisted thoracoscopic surgery (VATS) is a diagnostic method, used with increasing frequency in recent years, in the diagnosis of interstitial lung diseases. There are significant differences in the diagnosis of diseases which are diagnosed with clinical, biochemical and radiological investigation and with pathological evaluation of material obtained by VATS. In our study, five patients with different clinical and VATS guided pathological diagnosis, were analyzed. VATS was applied to four patients with clinical and radiological diagnosis of lymphangioleiomyomatosis, hypersensitivity pneumonitis and idiopathic pulmonary fibrosis (IPF) (two patients) at the beginning and to another patient with pulmonary tuberculosis (Tbc) who was ARB positive and no regression could be achieved with anti-Tbc treatment at the third month. Clinical and pathological diagnosis was different in all patients. In a 22 year old female, who was thought to be lymphangioleiomyomatosis, was pathologically diagnosed as histiocytosis-X; in a 55 year old female, who was thought to be hypersensitivity pneumonitis, was diagnosed as sarcoidosis; in a 58 year old male, who was thought to be IPF, was diagnosed as nonspecific interstitial pneumonia. Sixty-two year old patient with ARB positive pulmoner Tbc who had no clinical and radiological regression with three month anti-Tbc therapy, and 65 year old male patient who was thought to be IPF were diagnosed by VATS as bronchoalveolar carcinoma. In conclusion; VATS is one of the most important methods for definite diagnosis of interstitial lung diseases, in patients with interstitial involvement.