Open lung biopsy in children with diffuse pulmonary lesions

Area of Science:

• Pediatric Pulmonology
• Diagnostic Pathology

Background:

• Interstitial pulmonary lesions are common in children, particularly those undergoing immunosuppressive therapy for malignancy.
• Accurate diagnosis is crucial for effective treatment and management of pediatric lung diseases.

Purpose of the Study:

• To evaluate the diagnostic efficacy of open lung biopsy in children with interstitial pulmonary lesions.
• To determine the incidence of Pneumocystis carinii pneumonia (PCP) in immunocompromised children.

Main Methods:

• Open lung biopsy was performed on 33 children (1 month to 13 years) between 1973-81.
• Histological examination was used to diagnose or exclude PCP and other interstitial lung diseases.

Main Results:

• Clinical diagnosis was correct in only 55% of cases, while biopsy provided a definitive diagnosis for all patients.
• Pneumocystis carinii was identified in 67% of immunosuppressed patients.
• Nine patients (27%) experienced postoperative complications, with 3 requiring reoperation; one death was possibly related to surgery.

Conclusions:

• Open lung biopsy is the most reliable method for diagnosing diffuse interstitial pneumonitis in children.
• The benefits of open lung biopsy significantly outweigh the risks, even with the necessity of anesthesia.