Transbronchial lung biopsy in interstitial lung diseases at a tertiary care center in Western India

Abstract

Background: Interstitial lung diseases (ILDs) are a heterogeneous group of disorders with a wide spectrum. Diagnosis of ILD is by a multidisciplinary approach with clinical, radiological, and histopathological correlation. With the increasing knowledge on the clinical and radiological spectrum, there is a renewed interest to clarify and research the pathological aspect too. Materials and Methods: A retrospective study was conducted at a tertiary care hospital based on the available medical records of 65 patients with IEC permission. The role of transbronchial lung biopsy (TBLB) in diagnosing ILD was studied by comparing with high-resolution computed tomography findings. Data were analyzed in percentages. Results and Interpretation: Out of 65 cases, there were 30 cases (46%) of chronic hypersensitivity pneumonitis (HP), 12 cases (18%) of sarcoidosis, 12 cases (18%) of usual interstitial pneumonia (UIP), 9 cases (14%) of nonspecific interstitial pneumonia (NSIP), 1 case (2%) of lymphocytic interstitial pneumonia (LIP), and 1 (2%) case of cryptogenic organizing pneumonia (COP). TBLB yielded pathological diagnosis suggesting ILDs in 65% of patients. In addition, ill-formed granulomas were observed in 14 of 30 (47%) of chronic HP, noncaseating granulomas in 7 of 12 (58%) of sarcoidosis, and diffuse lymphocytic infiltrates and organizing pneumonia pattern in 100% of LIP and COP patients, respectively, whereas yield in cases of UIP and NSIP is 17% and 33%, respectively. Conclusion: Thus, TBLB is a promising minimally invasive technique for diagnosing ILD with a total yield of 65%. More specifically, the yield is more in cases of sarcoidosis, chronic HP, and rare ILDs such as LIP and COP, as compared to UIP and NSIP.