Significance of bronchoscopic lung biopsy in clinical practice

At present bronchoscopic lung biopsy (BLB) is widely used to diagnose various lung diseases. However placing of BLB in the diagnostic sequence of various clinical situations is not so clear. The purpose of the study was to evaluate the diagnostic value of BLB in a daily clinical practice.

The data obtained from the case records of all 304 patients who had undergone BLB since January 1996 to December 2007 at the Centre of Pulmonology and Allergology of Vilnius University Hospital Santariskiu klinikos (Vilnius, Lithuania) were examined.

Most of indications for BLB were a peripheral lung nodule (40% of all the cases), dissemination in the lung (24% of all BLBs) and non-resolving pulmonary infiltrates (16.3% of all biopsies). Adequate lung tissue for histological examination was obtained in 85% of the cases. Based on the pathological diagnosis and findings of other diagnostic methods the final clinical diagnosis was verified for most of the patients. However, at least in 8% of the cases, the final clinical diagnosis was yet syndromic. Of all the BLBs, serious complications occurred in 8 (2.6%) patients. Clinically significant pneumothorax requiring chest tube treatment occurred in 5 (1.6%) of 304 patients. Severe bleeding occurred in 3 (1%) out of all BLBs.

BLB is a relatively effective and safe method for diagnosing lung diseases. In most cases of the lung infiltrate, nodule, dissemination and diffuse changes, BLB is suitable to choose method for lung biopsy.