Lung biopsy in diagnosis of causes of lung involvement in hemoblastosis

Abstract

Aim. To ascertain the role of lung biopsy in diagnosis of lung lesions in hemoblastosis (HB) patients. Material and methods. The results of diagnostic biopsies of the lungs obtained from 22 HВ patients are presented. Ten patients had no respiratory insufficiency (RI), twelve patients had RI. The biopsy was transbronchial in 1 case, thoracoscopic in 10 and open in 11 cases. Results. In Rl-free patients lung biopsy was informative in all the cases. The biopsy provided information which allowed therapy modification resulting in improvement of the patient condition. In RI patients biopsy was informative in 8 of 12 patients. Nonspecific changes in the lungs were identified histologically in 2 of 12 patients. In 2 RI patients lung biopsy confirmed the diagnosis made after examination of the bronchoalveolar lavage. Modification of therapy after the biopsy was conducted in 58.3% HB patients with RI. Improvement was seen in 2 of them. 10 of 12 patients with RI died within 1-2 weeks after biopsy. Conclusion. Lung biopsy in HB patients should be obtained only after examination with noninvasive methods and before development of RI as prognosis after lung biopsy in the presence of RI is unfa- vourable. The histological material should be examined for all expected pathogens.

Keywords

• acute respiratory insufficiency
• pneumonia
• hemoblastosis
• lung biopsy
• cytomegalovirus
• pneumo- cystis cahnii
• fungal pneumonias
• obliterating bronchiolitis
• interstitial pulmonary fibrosis
• graft- against-host reaction