[Transbronchial lung cryobiopsy in interstitial lung diseases].

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Diagnostic Pathology

Context:

• Interstitial lung disease (ILD) diagnosis can be challenging, often requiring invasive procedures.
• Multidisciplinary discussion (MDD) integrating clinical, imaging, and biological data may not yield a definitive diagnosis.
• Histological confirmation is sometimes necessary for accurate ILD assessment.

Purpose:

• To evaluate the diagnostic yield and safety of transbronchial lung cryobiopsy (TBLC) in patients with ILD.
• To compare TBLC with conventional forceps biopsy and surgical lung biopsy.
• To assess the role of TBLC in the diagnostic algorithm for ILD.

Summary:

• Transbronchial lung cryobiopsy (TBLC) is a minimally invasive bronchoscopic procedure for ILD diagnosis.
• TBLC provides larger tissue samples than conventional biopsies, improving diagnostic yield.
• The procedure has an acceptable risk profile, mainly pneumothorax and bleeding, and is safer than surgical lung biopsy.
• TBLC, decided during MDD, achieves an approximate 80% diagnostic yield.
• TBLC is proposed as a first-line diagnostic tool in experienced centers, with surgical biopsy as a second-line option.

Impact:

• TBLC enhances the diagnostic capabilities for ILD, potentially reducing the need for more invasive procedures.
• It offers a safer and more effective alternative to conventional biopsies for obtaining lung tissue.
• The findings support the integration of TBLC into the initial diagnostic work-up for selected ILD patients.