L. Giuntoli*a (Dr), V. Luzzia (Dr), L. Ciania (Dr), M. Trigiania (Dr), L. Corbettaa (Prof), L. Goria (Dr), A. Soranoa (Dr), F. Potenzaa (Dr), S. Ferraroa (Dr), V. Pasinia (Dr), C. Ammatunaa (Dr), C. Comina (Prof), E. Rosia (Dr), F. Lavorinia (Prof), S. Tomassettia (Prof)

a AOU-Careggi, Florence, ITALY

* leogiuntoli@gmail.com

Introduction: Cryoprobe is a transbronchial biopsy (TBB) tool that yields larger tissue samples than forceps. TBLC has shown promise in several studies in providing meaningful histological information in other rare lung disease, slowly but steadily overcoming the necessities for surgical lung biopsy.

Objective: The purpose of this case series is to show that TBLC opens up unprecedented possibilities in the diagnosis of rare lung tumors, disease that where previously diagnosed only via surgical lung biopsy.

Methods: Here we show 4 clinical cases referred to our center during the past two years for lung nodules suspected for rare malignancies: all underwent TBLC as the first attempt into the histological characterization of such lesions.The first is a 14 y.o. female with no previous condition with a PET positive lung nodules found as part of the work-up for multiple episode of hemoptisys. The histological result was a myofibroblastic tumor.The second is a 30 y.o. female with no previous condition with multiple cystic lesions at chest-CT executed for dyspnea. The histological result was Langerhans cell histiocytosis, with mutation of the BRAF gene, and currently undergoing treatment with deratinibThe third is a 18 y.o female with “congenital encephalopathy” and previous surgical removal of thigh skin melanoma, found as part of the radiological FU. Th histological diagnosis was Pulmonary sclerosing pneumocytoma.The fourth case is a 43 y.o. woman affected by multiple sclerosis, with a peripheral lung lesion. The histological diagnosis was lymphoid hyperplasia

Results: Histologycal diagnosis was achieved in all cases without the need for further procedure. The quality of the samples allowed the necessary genetic and biomarkers studies to be performed. One procedure was complicated by pneumothorax.

Discussion: Rare lung diseases can now be easily diagnosed via cryobiopsy. Cryobiopsy is becoming a valid alternative to SLB for histopathological diagnosis in patients with rare lung tumors.

Disclosure of funding source(s): none