Chest
Clinical InvestigationsOutcomes and Safety of Surgical Lung Biopsy for Interstitial Lung Disease
Section snippets
Subjects
We retrospectively reviewed the records and radiographs of all patients who underwent SLB for suspected ILD at our institution between January 1996 and December 2002. We excluded from analysis all subjects < 18 years of age and those who had a history of biopsy-proven ILD. As defined by the American Thoracic Society statement on interstitial pneumonias, patients with suspected ILDs showed diffuse parenchymal infiltrates of varying degrees of inflammation or fibrosis that were not attributable
Results
During the study period, 88 patients underwent SLB. Complete data were lacking for five subjects, and these patients were excluded from further analysis. Hence, the final cohort included 83 individuals. As shown in Table 1, the mean age of the cohort was 57.3 ± 14.2 years, and slightly more than half were men. At the time of SLB, 45.8% of the subjects required supplemental oxygen therapy, and nearly one in five patients were immunocompromised. Slightly more than one quarter of SLBs (27.7%) were
Discussion
This retrospective analysis demonstrates the safety of performing SLB in patients with ILD, including those with IPF. More importantly, the diagnosis of IPF did not appear to increase the risk for either mortality or morbidity following SLB. The most important correlates of adverse outcomes were the need for MV at the time of SLB or being immunosuppressed. In the absence of either of these factors, death, as a complication of SLB, was rare, suggesting that mortality was more likely to be
ACKNOWLEDGMENT
The authors thank Steven Nathan, MD, for his helpful comments on earlier drafts of this article.
References (14)
- et al.
Radiologic findings are strongly associated with a pathologic diagnosis of usual interstitial pneumonia
Chest
(2003) - et al.
The accuracy of the clinical diagnosis of new-onset idiopathic pulmonary fibrosis and other interstitial lung disease: a prospective study
Chest
(1999) - et al.
Clinical features of non-specific interstitial pneumonia
Respir Med
(1999) - et al.
The role of open lung biopsy in the management and outcome of patients with diffuse lung disease
Ann Thorac Surg
(1998) American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias: this joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001
Am J Respir Crit Care Med
(2002)American Thoracic Society. Idiopathic pulmonary fibrosis: diagnosis and treatment; international consensus statement—American Thoracic Society (ATS), and the European Respiratory Society (ERS)
Am J Respir Crit Care Med
(2000)- et al.
CT-histologic correlation of the ATS/ERS 2002 classification of idiopathic interstitial pneumonias
Radiographics
(2003)
Cited by (132)
Idiopathic pulmonary fibrosis: Diagnosis, biomarkers and newer treatment protocols
2023, Disease-a-MonthCitation Excerpt :Clinical and radiological context should be emphasized in such cases to make a diagnosis of IPF instead, so as to spare such patients the penalties of SLB. However, it is also important to note that improved surgical techniques have rendered SLB much safer.198,201 Moreover, the classical radiological features required to make a diagnosis of UIP pattern are seen in approximately only half of the patients with IPF.189
Magnetic resonance imaging of interstitial lung diseases: A state-of-the-art review
2019, Respiratory MedicineCitation Excerpt :In the absence of a typical UIP CT pattern, surgical lung biopsy is advised for the final diagnosis [47]. However, lung biopsy is an invasive procedure, and associated mortalities rates from 2% to 7.1% have been reported in ILDs [48,49]. Thus far, evidence on the use of chest MR imaging in IPF is weak [50].
Lung Cancer Biopsies
2018, Radiologic Clinics of North AmericaSpontaneous Ventilation Thoracoscopic Lung Biopsy in Undetermined Interstitial Lung Disease: Systematic Review and Meta-Analysis
2024, Journal of Clinical Medicine
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestjournal.org/misc/reprints.shtml).
This work was presented in part in abstract form at the 2003 Annual Meeting of the American College of Chest Physicians. The opinions expressed herein are not to be construed as official or as reflecting the policies of either the Department of the Army or the Department of Defense.