Bronchial and transbronchial lung biopsy without fluoroscopy in sarcoidosis

Sixty-eight patients with a clinical diagnosis of sarcoidosis underwent flexible fiberoptic bronchial and transbronchial lung biopsies without the aid of fluoroscopy. Close observation of the normal respiratory excursions of the distal tracheobronchial tree and tactile sensations were found to be helpful in preventing pleural rupture. Sarcoidosis was histologically confirmed in bronchial or transbronchial tissue (or both) by this technique in 51 (76 percent) of 67 patients. Only a single pneumothorax and no significant bleeding resulted from this procedure. In the hands of experienced physicians, peripheral bronchial biopsies and transbronchoscopic lung biopsies are safe and accurate procedures even when performed in institutions where fluoroscopy is not immediately available.