lung biopsy

Pathology

• granuloma (sarcoidosis or hypersensitivity pneumonitis in the absence of mycobacterial or fungal infection)
• specific infectious agent
• malignancy
  • CT-guided lung biopsy
    • positive predictive value for lung cancer 99.8%
    • negative predictive value for lung caner 74%

Indications

bronchoscopic lung biopsy

• sarcoidosis
• pulmonary Langerhans cell granuloma
• eosinophilic pneumonitis
• lymphangioleiomyomatosis
• pulmonary infections
• pulmonary alveolar proteinosis
• lymphangitic carcinomatosis
• drug-induced lung disease
• hypersensitivity pneumonitis
• pulmonary nodule*

* most common reason for lung biopsy

Procedure

• bronchoscopic lung biopsy
• CT-guided lung biopsy

* needle aspiration rather than biopsy of lymph node diagnostic according to ref

Complications

• pneumothorax
  • <2% bronchoscopic lung biopsy
  • 37% CT-guided lung biopsy, 7% require chest tube
    • risk factors
      • age > 73
      • pulmonary emphysema
      • distance from pleura to lesion >= 1.5 cm
• hemorrhage (<3%) bronchoscopic lung biopsy

* bronchoscopic lung biopsy

# CT-guided lung biopsy

Notes

• absence of diagnostic findings on transbronchial lung biopsy does not exclude disease because of sampling errors despite multiple biopsies
• open lung biopsy may be indicated.

More general terms

• lung/mediastinal biopsy

More specific terms

• transbronchial biopsy

Additional terms

• bronchoscopy