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Background: Among patients with obstructive sleep apnea (OSA) a higher number of medical

Background Diffuse parenchymal lung diseases (DPLDs) are common. An accurate diagnosis is essential due to differences in etiology, cli nicopathologic features, therapeutic options and prognosis. Transbronchial lung biopsies (TBLB) are often limited by small specimen size, crush artifact and other factors. Transbronchial lung cryobiopsies (TBLC) are under investigation to overcome these limitations. Methods We conducted a retrospective study of 56 patients in a single, tertiary-care academic center in order to compare the yield of both techniques when performed in the same patient. Patients underwent flexible bronchoscopy using moderate sedation with TBLB followed by TBLC in the most radiographically abnormal areas. Clinical data and post-procedural outcomes were reviewed, with a final diagnosis made utilizing a multidisciplinary approach. Results The mean age was 60 and 53.6% were male. Co-morbidities included COPD (14%) and prior malignancy (48%). The number of TBLB specimens ranged from 1–10 per patient (mean 4) and size varied from 0.1–0.8 cm. The number of TBLC specimens ranged from 1–4 per patient (mean 2) and size ranged from 0.4–2.6 cm. Both techniques provided the same diagnosis in 26 patients (46.4%). An additional 11 (19.6%) patients had a diagnosis established by adding TBLC to TBLB. Compared to TBLB, TBLC had a higher diagnostic yield in patients with hypersensitivity pneumonitis and interstitial lung disease. Only two patients required video-assisted thoracoscopic surgery (VATS) to establish a diagnosis. Complications included pneumothorax (19.6%) and massive hemoptysis (1.8%). Conclusions TBLC used with TBLB can improve the diagnostic yield of flexible bronchoscopy in patients with DPLD.

Endothelial miR-1 is down-regulated in NSCLC tumors and controls tumor progression and angiogenesis.