Abstract
Lung biopsy through the airways by using a flexible bronchoscope (TBLB: trans-bronchial lung biopsy) is an appropriate method for obtaining tissue samples. In previous studies, type of forceps, sample size, floatation of the sample in the liquid and its alveolarity were suggested as factors impacting the diagnostic value of TBLB. This study aimed at evaluating the factors affecting TBLB results in order to increase the diagnostic value of this method.This was a prospective, double blind observational analysis.
We had a total of 44 patients with pulmonary lesions; each of these patients underwent 4 biopsies. Biopsy samples were taken using cup and alligator forceps alternatively. From 88 samples obtained by the alligator forceps, 16 were diagnostic while from the same number of specimens taken by the cup forceps, 21 samples had diagnostic value. Of the small sized samples (57 cases), 12 (21.1%) were diagnostic while among the 66 medium sized samples, 12 (18.2%) and from the 53 large sized samples, 13 (24.5%) were diagnostic. Among samples floating on the surface of the liquid (48 cases), 6 (12.5%) had diagnostic value. Of the 12 samples suspended in the liquid, 2 (16.7%) and among the 116 samples precipitated to the bottom, 29 (25%) were diagnostic.Of the 84 samples with more than 20 alveoli, 31 (36.9%) were diagnostic. Among 26 samples with number of alveoli less than 20, 5 cases (19.2%) were diagnostic.This correlation was statistically significant.
In a conclusion, number of alveoli present in the tissue sample was directly correlated with its diagnostic value. However, this study did not find a significant correlation between the diagnostic value of TBLB and type of forceps, sample size and floatation of the sample in the liquid.
- © 2011 ERS