Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure
Sergio Harari,
Francesca Cereda,
Federico Pane,
Alberto Cavazza,
Nikolaos Papanikolaou,
Giuseppe Pelosi,
Monica Scarioni,
Elisabetta Uslenghi,
Maurizio Zompatori,
Antonella Caminati
Affiliations
Sergio Harari
U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe-MultiMedica IRCCS, via San Vittore 12, 20123 Milan, Italy
Francesca Cereda
U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe-MultiMedica IRCCS, via San Vittore 12, 20123 Milan, Italy
Federico Pane
U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe-MultiMedica IRCCS, via San Vittore 12, 20123 Milan, Italy
Alberto Cavazza
U.O. di Anatomia Patologica Azienda USL/IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
Nikolaos Papanikolaou
Servizio Interaziendale di Anatomia Patologica, Polo Scientifico e Tecnologico, IRCCS MultiMedica, Via Gaudenzio Fantoli 16/15, 20138 Milan, Italy
Giuseppe Pelosi
Servizio Interaziendale di Anatomia Patologica, Polo Scientifico e Tecnologico, IRCCS MultiMedica, Via Gaudenzio Fantoli 16/15, 20138 Milan, Italy
Monica Scarioni
U.O. di Anestesia e Rianimazione, Ospedale San Giuseppe-MultiMedica IRCCS, Via San Vittore, 12, 20123 Milan, Italy
Elisabetta Uslenghi
Dipartimento di Diagnostica per Immagini e U.O. di Radiologia MultiMedica IRCCS, 20123 Milan, Italy
Maurizio Zompatori
Dipartimento di Diagnostica per Immagini e U.O. di Radiologia MultiMedica IRCCS, 20123 Milan, Italy
Antonella Caminati
U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe-MultiMedica IRCCS, via San Vittore 12, 20123 Milan, Italy
Introduction: Transbronchial cryobiopsy is an alternative to surgical biopsy for the diagnosis of fibrosing interstitial lung diseases, although the role of this relatively new method is rather controversial. Aim of this study is to evaluate the diagnostic performance and the safety of transbronchial cryobiopsy in patients with fibrosing interstitial lung disease. Materials and methods: The population in this study included patients with interstitial lung diseases who underwent cryobiopsy from May 2015 to May 2018 at the Division of Pneumology of San Giuseppe Hospital in Milan and who were retrospectively studied. All cryobiopsy procedures were performed under fluoroscopic guidance using a flexible video bronchoscope and an endobronchial blocking system in the operating room with patients under general anaesthesia. The diagnostic performance and safety of the procedure were assessed. The main complications evaluated were endobronchial bleeding and pneumothorax. All cases were studied with a multidisciplinary approach, before and after cryobiopsy. Results: Seventy-three patients were admitted to this study. A specific diagnosis was reached in 64 cases, with a diagnostic sensitivity of 88%; 5 cases (7%) were considered inadequate, 4 cases (5%) were found to be non-diagnostic. Only one major bleeding event occurred (1.4%), while 14 patients (19%) experienced mild/moderate bleeding events while undergoing bronchoscopy; 8 cases of pneumothorax (10.9%) were reported, of which 2 (2.7%) required surgical drainage. Conclusions: When performed under safe conditions and in an experienced center, cryobiopsy is a procedure with limited complications having a high diagnostic yield in fibrotic interstitial lung disease.
