Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2022.0031    [Accepted]
Published online August 2, 2022.
Transbronchial lung cryobiopsy for diagnosing interstitial lung disease: A retrospective single-center experience
Jin Han Park1, Ji Hoon Jang1, Hyun Kuk Kim1, Hang-Jea Jang1, Sunggun Lee2, Seong-Ho Kim2, Ji Yeon Kim3, Hee Eun Choi4, Ji-yeon Han5, Da Som Kim5, Min Kyun Kang6, Eunsu Kang7, Il Hwan Kim8, Jae Ha Lee1 
1Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
2Division of Rheumatology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
3Department of Pathology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
4Department of Physical Medicine and Rehabilitation, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
5Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
6Department of Thoracic and Cardiovascular Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
7Department of Anesthesiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
8Division of Oncology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
Correspondence:  Jae Ha Lee, Tel: +82-51-797-0457, Fax: +82-51-797-2210, 
Email: anilleus@naver.com
Received: 16 March 2022   • Revised: 4 May 2022   • Accepted: 27 June 2022
Abstract
Background
An accurate diagnosis in patients with interstitial lung diseases (ILDs) by multidisciplinary discussion (MDD) based on histopathologic information is essential for optimal treatment. Transbronchial lung cryobiopsy (TBLC) has increasingly been used as a diagnostic alternative to surgical lung biopsy. This study aimed to evaluate the appropriate methods of TBLC in patients with ILD in Korea.
Methods
A total of 27 patients who underwent TBLC were included. TBLC procedure details and clinical MDD diagnosis using TBLC histopathologic information were retrospectively analyzed.
Results
All procedures were performed under general anesthesia with the fluoroscopic guidance in the operation room using flexible bronchoscopy and endobronchial balloon blocker. The median procedure duration was less than 30 minutes, and the median number of biopsies per participant was 2. Most of the bleeding after TBLC was not severe, and the rate of pneumothorax was 25.9%. The most common histopathologic pattern was alternative (48.2%), followed by indeterminate (33.3%) and usual interstitial pneumonia (UIP)/probable UIP (18.5%). In the MDD after TBLC, the most common diagnosis was idiopathic pulmonary fibrosis (33.3%), followed by smoking-related ILD (25.9%), nonspecific interstitial pneumonia (18.6%), unclassifiable-ILD (14.8%), and others (7.4%).
Conclusions
This first single-center experience showed that TBLC using a flexible bronchoscopy and endobronchial balloon blocker with the fluoroscopic guidance under general anesthesia may be a safe and adequate diagnostic method for ILD patients in Korea. The diagnostic yield of MDD was 85.2%. Further studies are needed to evaluate the diagnostic yield and confidence of TBLC.
Key Words: Interstitial lung disease, Diagnosis, Transbronchial lung cryobiopsy, Multidisciplinary discussion
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ORCID iDs

Jae Ha Lee
https://orcid.org/0000-0003-0932-2826

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