[Practical issues of transbronchial lung biopsy (TLB) in pneumology]

We present a survey of 78 TLB which have been performed in Bronchology Service (during 2003-2005) for diffuse interstitial lung diseases--70 cases or located diseases--8 cases; TLB was not performed for solitary peripherally opacities because we have no radiological device with mobile arm (for good position of forceps).

In 78% of cases we obtained illustrative lung tissue and in 22% of cases we prelevated just bronchial wall. Histological confirmation was obtained for 53% of cases; 47% of cases have as result lung tissue without significant modifications. Histological diagnosis was obtain in 41% of cases. The diagnosis of lung pathology was: diffuse lung fibrosis, tuberculosis, sarcoidosis stage II-III, malignant lymphoma, carcinomatosis, undifferentiated carcinoma, bronchioloalveolar carcinoma, squamous carcinoma, adenocarcinoma. There were 5 cases (6%) of small pneumothorax with spontaneous resorption and 11 cases with small bleeding (5-10 ml) who stopped spontaneously or at local administration of xilometasolin or oximetasolin. No other incidents were registered.

TLB is a good alternative of surgical biopsy. The international guidelines request that the TLB has to be made before the thoracoscopy or the thoracotomy; because of the small size of prelevated fragments the diagnosis sensibility is variable. Our results for the 78 cases are comparable with the international data from literature both from the point of view of the diagnosis and the complications.