Bronchoscopic Myths and Legends: Utility of Bronchoscopy in ILD: A Review Article

Interstitial lung diseases (ILDs) also known as diffuse parenchymal lung diseases can be a diagnostic dilemma, as treatment and prognosis depend largely on an accurate diagnosis. A multidisciplinary approach has become standard of care and has been shown to be the key to making the correct diagnosis with the least invasive approach. This usually comprises pulmonologists, rheumatologists, radiologists, and pathologists, and is essential to reach the correct and final diagnosis. Histologic diagnosis was considered in the past to be the end and be all for the definite diagnosis of ILDs. However, this is not the case anymore. It is now possible to make a definite diagnosis of certain ILDs such as idiopathic pulmonary fibrosis based off clinical presentation, serologies, and high-resolution computed tomography of the chest if it has typical features without the need for bronchoalveolar lavage or histology. Not all suspected ILDs need to be biopsied! An accurate diagnosis is essential due to differences in etiology, clinicopathologic features, therapeutic options, and prognosis. This article reviews where the literature stands now on the utility of bronchoscopy in diagnosing ILDs.