We believe that Drs. Mukherjee and Spiteri misinterpreted the message of our article (May 2006).1This work was intended to highlight a hypothesis that will require further testing. It was not intended to generate a clinical recommendation to use transbronchial lung biopsies (TBBs) to diagnose usual interstitial pneumonia (UIP). In our article, we clearly stated that TBBs should be tested in a blinded fashion, and in a cohort of patients with diffuse lung diseases, including UIP and non-UIP cases. However, it is undeniable, as we show in several of our figures, and despite the relatively small sizes of the TBB specimens, that in patients with well-characterized UIP from surgical or explanted lung specimens, features specific for UIP such as a patchwork pattern of interstitial fibrosis, fibroblastic foci, and honeycomb change2–3 are readily recognizable in many TBB specimens.3We agree that in these small specimens one may not identify discordant pathology. However, since the prognosis associated with “discordant” or “concordant” UIP is the same, recognizing the UIP findings will dictate the ultimate prognosis.4We believe that these finding are quite important and should be considered as a step forward, not backward as suggested by Mukherjee and Spiteri. Unfortunately, it has become widely accepted, despite a lack of convincing evidence, that TBBs are not useful in diagnosing idiopathic interstitial pneumonias. However, if in the future TBBs are proven to be useful in diagnosing UIP from a pool of patients with diverse diffuse lung diseases, many unnecessary surgical lung biopsy procedures, with the associated morbidity, mortality, and cost, could be prevented.5 Our study plants the seeds for what could turn out to be a very important step forward in the field.