SESSION TYPE: Interesting Topics in ILD
PRESENTED ON: Tuesday, October 23, 2012 at 02:45 PM - 04:15 PM
PURPOSE: To demonstrate the safety, usefulness and feasibility of lung biopsy by medical thoracoscopy in patients with DPLDs on HRCT chest of unconfirmed diagnosis after evaluation with less invasive investigations.
METHODS: The study included 10 patients with DPLDs of unknown etiology. Medical thoracoscopic lung biopsies were taken and sent for histopathologic examination. Follow up of the patients including chest X-ray for confirmation of lung expansion, observation of the intercostal tube for any complications after the procedure.
RESULTS: Good biopsy specimens were obtained in all patients with average size 0.5 ×0.4 cm. Two patients (20%) had persistent air leak for 5 &7 days then resolved spontaneously. Two patients (20%) had pneumothorax after removal of the intercostal tube and resolved by administration of high flow oxygen, 6 patients (60%) had pain and one patient (10%) had minor bleeding. The duration of the intercostal tube was 3.1 + 2.6 days. There was no infection, no respiratory failure requiring ICU admission and no mortality (30 day post procedure).
CONCLUSIONS: Thoracoscopic lung biopsy by medical thoracoscopy is useful in diagnosis of cases with DPLDs of unknown etiology when lung biopsy is needed for accurate diagnosis.
CLINICAL IMPLICATIONS: The procedure is feasible and safe. It carries some complications that are not life threatening and can be minimized by good selection of patients. No need for surgical lung biopsy.
DISCLOSURE: The following authors have nothing to disclose: Mohamed Elnady, Alaa Shalaby, Abdel Rhaman Mohamed
No Product/Research Disclosure InformationCairo University Hospitals, Cairo, Egypt