[The diagnostic value of transbronchial lung biopsy in diffuse parenchymal lung diseases].

Objective: This study was to evaluate the efficacy and limitations of transbronchial lung biopsy (TBLB) in the diagnosis of diffuse parenchymal lung diseases (DPLD).

Methods: TBLB was performed in 416 patients with diffuse lung diseases from January 2001 to October 2006 in Peking Union Medical College Hospital. The results of clinical data and pathologic diagnosis were retrospectively analyzed.

Results: Confirmed diagnosis by TBLB was obtained in 124 patients, the total positive diagnostic rate was 29.8%. The diseases included pulmonary sarcoidosis (52/124, 41.9%), bronchiolitis obliterans organizing pneumonia/organizing pneumonia (BOOP/OP) (28/124, 22.6%), pulmonary alveolar proteinosis (19/124, 15.3%), lung cancer (12/124, 9.7%), pulmonary vasculitis (5/124, 4.0%), pulmonary tuberculosis (3/124, 2.4%), and pneumocystis carinii pneumonia, lung fungal infection, lymphangiomyomatosis, and pulmonary amyloidosis (each 1/124, 0.8%). Open lung or thoracoscopic biopsy was performed in 104 cases in whom the diagnosis was undetermined by TBLB. Confirmed diagnosis was obtained in 109 patients, including nonspecific interstitial pneumonia (37/104, 37.7%), usual interstitial pneumonia (18/104, 18.4%), pulmonary sarcoidosis (11/104, 11.2%), BOOP/OP (6/104, 6.1%), and lung cancer (5/104, 5.1%).

Conclusions: Pathologic diagnosis can be obtained by TBLB in about 30% of the cases with DPLD, and therefore it should be considered to be a routine diagnostic procedure before open lung or thoracoscopic biopsy.