Utility of Transbronchial vs Surgical Lung Biopsy in the Diagnosis of Suspected Fibrotic Interstitial Lung Disease

Sheth, Jamie; Belperio, John A.; Fishbein, Michael C.; Kazerooni, Ella A.; Lagstein, Amir; Murray, Susan; Myers, Jeff L.; Simon, Richard H.; Sisson, Thomas H.; Sundaram, Baskaran; White, Eric S.; Xia, Meng; Zisman, David A.; Flaherty, Kevin R.

doi:10.1016/j.chest.2016.09.028

Cited by 95 publications

(70 citation statements)

References 44 publications

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“…Prior studies have demonstrated characteristic findings of HP in only 11–25% of TBBx [19, 28, 29]. In contrast to prior studies, TBBx was characteristic of HP in 40.2% of all patients in our study who underwent TBBx and in 46.2% of patients who had < 20% BAL lymphocytes.…”

Section: Discussioncontrasting

confidence: 96%

“…Transbronchial biopsy (TBBx) can be diagnostic in certain forms of ILD, such as granulomatous lung disease [27]. While tissue obtained from TBBx may be inadequate or nondiagnostic [19, 28, 29], TBBx can be performed at the same time as the BAL and has the potential to confer additive information regarding diagnosis with only minimal increase in risk [30, 31]. …”

Section: Introductionmentioning

confidence: 99%

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Utility of Bronchoalveolar Lavage and Transbronchial Biopsy in Patients with Hypersensitivity Pneumonitis

Adams

Newton

Batra

et al. 2018

Lung

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Section: Discussioncontrasting

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Utility of Bronchoalveolar Lavage and Transbronchial Biopsy in Patients with Hypersensitivity Pneumonitis

Adams

Newton

Batra

et al. 2018

Lung

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“…Several studies have clearly shown that TBCx provides larger specimens with fewer artefacts (figure 2) than regular forceps transbronchial biopsies (TBBx). In our previously published series [30], we reported a sensitivity for UIP detected by TBBx of only 30% for expert pathologists, and these data have recently been confirmed in a study that found TBBx useful to reach a confident and accurate multidisciplinary diagnosis in only 20-30% of patients with DPLDs, with the majority of cases requiring surgical lung biopsy (SLB) to secure a definite diagnosis [31]. By contrast, TBCx specimens are largely comparable to SLB, although the TBCx diagnostic yield falls short of that for SLB (80% for TBCx versus >90% for SLB), so TBCx has the potential to remove the need for surgery for a large proportion of patients.…”

Section: Multidisciplinary Diagnosis Of Dplds: All That Glitters Is Nmentioning

confidence: 99%

Diffuse parenchymal lung disease

Tomassetti¹,

Ravaglia²,

Poletti

2017

Eur Respir Rev

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Between September 2015 and August 2016 there were >1500 publications in the field of diffuse parenchymal lung diseases (DPLDs). For the Clinical Year in Review session at the European Respiratory Society Congress that was held in London, UK, in September 2016, we selected only five articles. This selection, made from the enormous number of published papers, does not include all the relevant studies that will significantly impact our knowledge in the field of DPLDs in the near future. This review article provides our personal view on the following topics: early diagnosis of idiopathic pulmonary fibrosis, current knowledge on the multidisciplinary team diagnosis of DPLDs and the diagnostic role of transbronchial cryobiopsy in this diagnostic setting, insights on the new entity of interstitial pneumonia with autoimmune features, and new therapeutic approaches for scleroderma-related interstitial lung disease.

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“…Although conventional transbronchial biopsy has a low yield for the diagnosis of ILD (20–30%) , transbronchial cryobiopsy represents a promising intermediary technique. Cryobiopsy combines flexible bronchoscopy with a cryoprobe to remove biopsy specimens of >5 mm in size, a threshold that has been considered sufficient for a diagnosis of ILD.…”

Section: Introductionmentioning

confidence: 99%

Interstitial Pneumonia With Autoimmune Features

Wilfong

Lentz

Guttentag

et al. 2018

Arthritis & Rheumatology

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Interstitial lung disease (ILD) remains a cause of significant morbidity and mortality in patients with connective tissue disease (CTD)-associated ILD. While some patients meet clear classification criteria for a systemic rheumatic disease, a subset of patients do not meet classification criteria but still benefit from immunosuppressive therapy. In 2015, the American Thoracic Society and European Respiratory Society described classification criteria for interstitial pneumonia with autoimmune features (IPAF) to identify patients with lung-predominant CTD who lack sufficient features of a systemic rheumatic disease to meet classification criteria. Although these criteria are imperfect, they are an important attempt to classify the patient with undifferentiated disease for future study. Rheumatologists play a key role in the evaluation of potential IPAF in patients, especially as many patients with a myositis-spectrum disease (e.g., non-Jo-1 antisynthetase syndrome, anti-melanoma differentiation-associated protein 5 antibody inflammatory myositis, or anti-PM/Scl antibody-associated inflammatory myositis) would be classified under IPAF using the currently available criteria for inflammatory myositis, and would therefore benefit from rheumatologic comanagement. The aim of this review was to describe the historical context that led to the development of these criteria and to discuss the limitations of the current criteria, diagnostic challenges, treatment options, and strategies for disease monitoring.

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Utility of Transbronchial vs Surgical Lung Biopsy in the Diagnosis of Suspected Fibrotic Interstitial Lung Disease

Abstract: Information from TBB, when combined with clinical and HRCT data, may provide enough information to make a confident and accurate diagnosis in approximately 20% to 30% of patients with ILD.

Cited by 95 publications

References 44 publications

Utility of Bronchoalveolar Lavage and Transbronchial Biopsy in Patients with Hypersensitivity Pneumonitis

Utility of Bronchoalveolar Lavage and Transbronchial Biopsy in Patients with Hypersensitivity Pneumonitis

Diffuse parenchymal lung disease

Interstitial Pneumonia With Autoimmune Features

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