Cystic lung lesion following transbronchial lung cryobiopsy: Case report and systematic review

Abstract

Transbronchial lung cryobiopsy (TBLC) is a technique used to sample the lungs for diagnosing diffuse lung diseases. A sizeable tissue is sheared off the lung parenchyma during TBLC leading to a defect in the lung, which might result in a cystic lesion on imaging. Computed tomography (CT) performed for other reasons might incidentally reveal such a cyst. We report a 75-year-old patient who underwent TBLC and developed significant intraprocedural bleeding. Chest CT performed for worsening breathlessness revealed an acute exacerbation (AE) of the underlying interstitial lung disease, and incidentally showed a new cyst in the biopsied lung lobe. The patient recovered clinically after the administration of high-dose methylprednisolone. A chest CT performed nine months later showed resolution of the lung cyst. A systematic review of the literature revealed that cysts/pneumatoceles/cavities may appear in 50% of patients following TBLC. About 90% are due to biopsy trauma and mostly resolve spontaneously. Rarely, a cavity may be due to infection; antimicrobial agents should be administered in such cases.

Keywords

• bronchoscopy
• hypersensitivity pneumonitis
• ild
• interstitial lung disease
• lung cryobiopsy