Atypical Histology in Pulmonary Biopsies Obtained Using Robotic-Assisted Bronchoscopy: Natural History and Clinical...

Area of Science:

• Pulmonology
• Oncology
• Pathology

Background:

• Atypical cells in biopsy results are often considered non-diagnostic.
• Investigating the malignancy rate and clinical outcomes of atypical cells is crucial.

Purpose of the Study:

• To determine the natural history and malignancy rate of atypical cells in non-diagnostic biopsy specimens.
• To analyze clinician practice patterns when encountering atypical cells in biopsy results.

Main Methods:

• Subset analysis of a prospective, multicenter robotic-assisted bronchoscopy study.
• Included non-diagnostic samples with and without atypical cells.
• Defined benign/malignant outcomes based on lesion size changes or repeat biopsy over 12 months.

Main Results:

• Malignancy was diagnosed in 68% of non-diagnostic biopsies with atypical cells (NDwA) versus 33% without (NDwo).
• 21% of NDwA patients were referred directly to cancer therapy, compared to 4.6% of NDwo.
• Atypical cells in non-diagnostic biopsies significantly increased the likelihood of malignancy.

Conclusions:

• Over two-thirds of non-diagnostic biopsies with atypical cells ultimately manifest as malignancy.
• A significant proportion of patients with atypical cells are referred for treatment without further diagnostic evaluation.