[Diagnosis of localized pulmonary opacities by transbronchial biopsy]

In order to assess the value of transbronchial biopsy (BTB) in the diagnosis of local pulmonary opacities, we have carried out a prospective study from October 1981 to August 1982 on 180 patients with a localised pulmonary opacity radiographically. 73 presented with a tumour visible fibreoptically in whom the diagnosis was made by bronchial biopsy. In 56 patients the clinical and biological picture were not suggestive of a malignancy and the lesion disappeared in 15 days on antibiotic treatment. Finally in 51 subjects the cancerous nature of the opacity was strongly suspected and the indication for a BTB were met. We obtained the following results: among 51 patients 11 were suffering from the sequelae of non-progressive disease and 40 of progressive disease; namely a sensibility of 80% and a specificity of 100%. The results vary as a function of the size of the tumour and its localisation. The best results were obtained for tumours with a diameter of greater than 3 cm, in the middle third of the lung (diagnosed by BTB 9 times out of 10). Thus transbronchial biopsy seems to be the first invasive examination to contemplate in the diagnosis of localised pulmonary opacities.