Histopathologic findings of transbronchial biopsy in usual interstitial pneumonia

The role of transbronchial biopsy in diagnosis of usual interstitial pneumonia (UIP) is controversial. In this study, we retrospectively reviewed transbronchial biopsy specimens according to the similar criteria of previous studies, and evaluated whether diagnostic findings of UIP could be found in transbronchial biopsies. Thirty two patients with usual interstitial pneumonia, confirmed by surgical lung biopsy, were identified. In three cases (9.4%), there were combinations of interstitial fibrosis and fibroblast foci, and these findings were considered consistent with usual interstitial pneumonia. No patchwork fibrosis or honeycomb change was found. Diagnostic findings of usual interstitial pneumonia were not frequently manifested in transbronchial biopsy specimens in our study (3 out of 32 cases, 9.4%), compared with a previous report (9 out of 22 cases, 41%). In conclusion, it cannot be claimed that transbronchial biopsy is more useful in confirming usual interstitial pneumonia than previously recognized. The primary and main role of transbronchial biopsy in diagnosis of usual interstitial pneumonia is thought not to confirm a diagnosis, but to exclude other infiltrative diseases, such as malignancy, sarcoidosis or infections.