Endobronchial and transbronchial biopsies in children

The aim of this review is to describe the indications, techniques and side effects of bronchial biopsies in children. At present, two different types of bronchial biopsies are currently used: endobronchial biopsies (EBBs) and transbronchial biopsies (TBBs). These procedures are becoming more diffuse thanks to the extensive use of pediatric fiber optic bronchoscopes (FOBs). EBBs can be used to obtain specimens from the bronchial wall and from endobronchial masses, while TBBs permit collection of samples from peripheral lung parenchyma. The use of FOBs with a working channel of more than 2 mm in diameter allows the utilization of adequate forceps to obtain good specimens, even in children less than 2 years of age. This amplifies the research field of persistent lung diseases, such as cystic fibrosis and bronchial asthma. The main contraindication to perform bronchial biopsies is bleeding disorders. For research purposes, it is mandatory to obtain the approval of the Institutional Ethical Committee, the signed consent of the parents and the age-appropriate assent of the child.