[Mini-invasive methods for diagnosis of diffuse interstitial lung disease]

Area of Science:

• Pulmonology
• Diagnostic Medicine
• Surgical Pathology

Background:

• Diffuse interstitial lung disease (DILD) diagnosis often requires invasive procedures.
• Accurate staging and tissue sampling are crucial for effective DILD management.
• Various biopsy techniques carry distinct risks and benefits.

Purpose of the Study:

• To delineate the role of invasive diagnostic methods in suspected DILD.
• To compare the diagnostic yield and safety profiles of different biopsy approaches.
• To establish clear indications and contraindications for lung and lymph node biopsies in DILD.

Main Methods:

• Review of transbronchial biopsy (TBB) procedures and outcomes.
• Analysis of video-assisted thoracoscopic surgery (VATS) biopsy efficacy and safety.
• Evaluation of open lung biopsy (OLB) for DILD diagnosis.
• Assessment of intrathoracic lymph node biopsy utility.

Main Results:

• Transbronchial biopsy offers a less invasive option but may have lower diagnostic yield.
• Video-assisted thoracoscopic surgery provides larger tissue samples with acceptable morbidity.
• Open lung biopsy remains a gold standard for definitive diagnosis when other methods fail.
• Lymph node biopsy can be valuable in specific DILD subtypes.

Conclusions:

• The choice of biopsy method in DILD depends on clinical suspicion, disease extent, and patient factors.
• A stepwise approach, balancing diagnostic information with procedural risk, is recommended.
• Careful patient selection and procedural expertise are paramount for safe and effective DILD diagnosis.