Transbronchial cryobiopsy as a new tool for lung biopsies in diagnosis of diffuse parenchymal lung diseases

Rationale and background The use of flexible forceps for transbronchial lung biopsy is the most commonly applied technique in the approach of diagnosis of diseases diffusely involving the lung parenchyma. Using a flexible cryoprobe for transbronchial lung biopsy has been also recently reported. Objective The aim was to study the diagnostic yield and to assess the feasibility of flexible cryoprobe in obtaining lung biopsies using flexible bronchoscopy. Patients and methods A total of 23 patients showing diffuse parenchymal lung affection in their radiology were included. They were recruited for transbronchial lung cryobiopsy. The flexible cryoprobe was directed into the preselected bronchus from the previously studied radiology. After the probe was brought into position, it was cooled and then retracted containing a frozen lung tissue attached to its tip. Then the obtained tissue was processed and sent for histopathology. Results Flexible probe lung cryobiopsy achieved overall diagnostic yield of 95.6% (22/23 patients). The most frequent diagnosis was hypersensitivity pneumonitis and idiopathic interstitial pneumonias. Each was diagnosed in 26.08% of the studied patients. Sarcoidosis and malignancy were the second frequent diagnoses obtained (each was diagnosed in 21.74% of patients). Pneumothorax (8.69%) and bleeding (4.35%) were recorded as the complications of cryotransbronchial lung biopsy in the study. Conclusion Lung cryobiopsy is a newly introduced technique that allows obtaining large biopsies of the lung parenchyma, which exceed the results of forceps biopsy in quality and size.