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Transbronchial Lung Biopsy

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Interventional Bronchoscopy

Part of the book series: Respiratory Medicine ((RM,volume 10))

Abstract

Transbronchial Lung biopsy (TBBx) also known as “Bronchoscopic Lung Biopsy” is one of the most important sampling procedures performed during flexible bronchoscopy. In majority of cases, TBBx is performed under conscious sedation in an outpatient setting. TBBx is performed for obtaining tissue specimen from peripheral lung masses and focal or diffuse lung infiltrates. The technique is useful in patients with suspected lung cancer, fungal and mycobacterial lung infections, unexplained infiltrates in immunocompromised hosts and in patients with suspected pulmonary sarcoidosis, lymphangitic carcinomatosis, and in selected cases of pulmonary Langerhan’s cell histiocytosis, lymphangioleiomyomatosis, and cryptogenic organizing pneumonia. TBBx also plays important role in assessment of rejection and infectious complications following lung transplantation.

TBBx is not useful for histological diagnosis of idiopathic pulmonary fibrosis or for distinguishing histological subtypes of idiopathic interstitial pneumonia. The diagnostic yield is also suboptimal in lung nodules smaller than 2 cm in diameter. Several recent techniques such as radial probe endobronchial ultrasound with guide sheath, electromagnetic navigation bronchoscopy, and virtual bronchoscopy navigation have been devised to improve the diagnostic yield of TBBx for solitary lung nodule. Hemoptysis and pneumothorax are the two leading complications of TBBx, occurring in less than 2 % of cases. Every bronchoscopists must be able to perform TBBx.

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Authors and Affiliations

  1. Pulmonary and Critical Care, Louis A Johnson VA Medical Center, Clarksburg, WV, 26301, USA

    Prasoon Jain M.B.B.S., M.D., F.C.C.P.

  2. Pulmonary and Critical Care Medicine, West Virginia University, Morgantown, WV, USA

    Sarah Hadique M.D.

  3. Respiratory Institute, Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, 44195, USA

    Atul C. Mehta M.B.B.S.

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  1. , Pulmonary, Allergy and Critical Care Med, Cleveland Clinic, Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Atul Mehta

  2. , Pulmonary and Critical Care Medicine, Louis A. Johnson VAMC, Medical Center Drive 1, West Virginia, 26301, USA

    Prasoon Jain

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Jain, P., Hadique, S., Mehta, A.C. (2013). Transbronchial Lung Biopsy. In: Mehta, A., Jain, P. (eds) Interventional Bronchoscopy. Respiratory Medicine, vol 10. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-395-4_2

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