Outcomes of transbronchial and transthoracic biopsy in pulmonary diseases

Abstract

AIM: contribution of invasive methods- transbronchial (TBLB) and transthoracic biopsy (TTNA) in the diagnostics of certain chest X- ray infiltrations. MATERIAL-METHODS: 76 - aged 41 to 83 years, out/ inpatient 14/ 62, male/ female 64/12 with lung and/or mediastinal changes, were analyzed since January 2015 to 2017. Bronhoscopic examination (before TTNA) excluded abnormalities. RESULTS: 92 biopsies were made (30 TBLB, 62 TTNA, in 16 patients both methods). TBLB- 14 patients, TTNA- 46 patients, both- 16 patients. TBLB with histological confirmation was obtained in 8 (57%) of 14 cases (4 in the first and 4 in the repeated TBLB), and in 42 (91%) of 46 made of TTNA. In 16 patients in which both methods (TBLB and TTNA) were performed, defined histological diagnosis was obtained in 4 samples of TBLB (also confirmed with TTNA), and in 12 samples of the TTNA. Defined histological diagnosis was not obtained in 18 of 30 TBLB (12 of them clarified by TTNA) and in 8 of 62 TTNA. 62 patients (81.5%) had a histopathological confirmation: 34 Carcinoma planocellulare bronchogenes; 10 Carcinoma microcellulare bronchogenes; 14 Adenocarcinoma; 4 Sarcoidosis. CONCLUSION: TBLB and TTNA are safe and cost effective diagnostic methods for definitive diagnosis of the changes in chest wall, lung parenchyma and mediastinum. Strategy of treating bronchial carcinoma requires clear histopathological classification, and therefore at sufficiently defined histological forms indicated repeating both methods. Usage of both TBLB and TTNA, even though with congruent histopathologic findings, has strengthened definitive diagnosis, which was confirmed with our results.