Transbronchial lung cryobiopsy in sarcoidosis – multiple vs single biopsy
M. Gnass*a (Dr), S. Orzechowskia (Dr), A. Bartczaka (Dr), D. Czyżewskib (Prof), A. ćmielc (Prof), J. Sojad (Prof), A. Szlubowskia (Prof)
a Pulmonary Hospital in Zakopane, Zakopane, POLAND ; b Medical University of Silesia, Katowice, POLAND ; c Department of Applied Mathematics, AGH University of Science and Technology, Cracow, POLAND ; d Jagiellonian University in Cracow, Cracow, POLAND
* m.gnass@gmail.com
INTRODUCTION: Transbronchial lung cryobiopsy (TBLC) is widely used in diagnosing interstitial lung diseases. Two to five biopsies from two different sites should be taken according to the current approach. The main complications of this procedure are pneumothorax and bronchial bleeding. The complication rate is correlated, among others, with number of biopsies.
OBJECTIVES: On the basis of our five years experience in TBLC guided with radial EBUS miniature probe we hypothesized that in patients suspected of stage III sarcoidosis performing single biopsy could be effective enough for histological diagnosis and allow to minimize complications.
METHODS: A multicenter Polish retrospective study to analyze TBLC efficacy and complications in patients with stage III sarcoidosis was performed.
RESULTS: Since March 2017 to January 2022 57 patients (M:32;F:25) of mean age (SD) 46.7 (10.5) years were identified. Multiple biopsy (2-4) was performed in 34 cases and single in 23. Mean (SD) biopsy number was 1.75 (0.74). Sensitivity and accuracy were 96.8% and 97.06% in multiple biopsy group and 95.45% and 95.83% in single biopsy group. The difference between groups was insignificant (P=0.87). Specificity was 100% in both. Location of the biopsy (upper vs middle/lower lobes) and consolidations visible in ultrasound imaging did not influence significantly on the result (P=0.2 and 0.23 respectively). But the tendency for higher yield in upper lobes and with positive ultrasound findings was observed. Pneumothorax was observed in 3 cases, 1 requiring chest tube. No mild or severe bleeding was noticed.
CONCLUSIONS: Taking single biopsy by TBLC with radial EBUS guidance seems to be efficient enough for diagnosing patients suspected of stage III sarcoidosis.
Disclosure of funding source(s): none