Endobronchial and transbronchial biopsies in children

Area of Science:

• Pediatric Pulmonology
• Interventional Pulmonology
• Pediatric Respiratory Medicine

Background:

• Bronchial biopsies are crucial for diagnosing persistent lung diseases in children.
• The increasing use of pediatric fiber optic bronchoscopes (FOBs) has facilitated these procedures.
• Endobronchial biopsies (EBBs) and transbronchial biopsies (TBBs) are the primary techniques employed.

Purpose of the Study:

• To review the indications for performing bronchial biopsies in pediatric patients.
• To describe the techniques of endobronchial biopsies (EBBs) and transbronchial biopsies (TBBs).
• To outline the potential side effects and contraindications associated with pediatric bronchial biopsies.

Main Methods:

• Review of current literature and clinical practices regarding pediatric bronchial biopsies.
• Description of endobronchial biopsies (EBBs) for bronchial wall and mass sampling.
• Description of transbronchial biopsies (TBBs) for peripheral lung parenchyma sampling.
• Emphasis on the use of pediatric fiber optic bronchoscopes (FOBs) with adequate working channel diameters (>2 mm) for optimal specimen collection, even in infants.

Main Results:

• Endobronchial biopsies (EBBs) are suitable for sampling the bronchial wall and endobronchial masses.
• Transbronchial biopsies (TBBs) allow for the collection of samples from the peripheral lung parenchyma.
• Adequate specimen acquisition is achievable in children under 2 years using FOBs with larger working channels.
• These techniques expand diagnostic capabilities for conditions like cystic fibrosis and asthma.

Conclusions:

• Pediatric bronchial biopsies, utilizing EBBs and TBBs with FOBs, are valuable diagnostic tools.
• The procedures are increasingly accessible, even for very young children, aiding in the diagnosis of persistent lung diseases.
• Bleeding disorders represent the primary contraindication, and ethical approvals are mandatory for research.