Feasibility of CT-Guided Percutaneous Needle Biopsy in Early Diagnosis of BOOP

Abstract

Bronchiolitis obliterans organizing pneumonia (BOOP) is a nonneoplastic, noninfectious lung disease with a diverse spectrum of imaging abnormalities and nonspecific symptoms diagnosed by open lung biopsy, transbronchial biopsy, and/or video-assisted thoracoscopy. The objective of this study was to retrospectively assess the role of percutaneous computed tomography (CT)-guided biopsy in early diagnosis of the disorder. Fourteen BOOP cases diagnosed by CT-guided biopsy were analyzed in terms of imaging abnormalities and complication rate. All had previously undergone a nondiagnostic procedure (bronchoscopy, transbronchial biopsy, bronchoalveolar lavage) to exclude infection or lung cancer. The most common imaging abnormalities in descending order were bilateral consolidations (5/14), unilateral tumor-like lesions (5/14), unilateral consolidations (3/14), and diffuse reticular pattern (1/14). Coexistent abnormalities (pleural effusions, nodules, ground-glass opacities) were observed in five patients. The complication rate was 4 of 14 (28.6%), including 2 cases of subclinical pneumothorax and 1 case of minor hemoptysis and local lung injury. None required intervention. We conclude that transthoracic CT-guided biopsy may be used in the diagnosis of BOOP in selected patients with mild complications. For the focal consolidation nodule/mass imaging pattern, CT-guided biopsy may prove to be a reasonable alternative to more invasive procedures.

Computed tomography-guided needle aspiration and biopsy of pulmonary lesions: a single-center experience in 1000 patients

“…FNA is optimally used in peripheral nodules, while CNB can be reserved for cases where FNA fails to provide a specific diagnosis, especially in cases of benign disease (10). In our series, a negative but specific result was obtained in 3%, including 12 cases of COP, suggesting that this approach is a viable alternative for confirming diagnosis, as previously described (11). CNB is more likely than FNA to provide a specific benign result.…”

Cryptogenic Organizing Pneumonia

“…Core needle biopsy is generally safe and may be appropriate in a minority of patients with suspected OP, [98][99][100][101] especially with focal consolidation at imaging. Lung specimens obtained by core needle biopsy are much larger than TBBs, and these may allow a more confident pathological diagnosis.…”

Diagnostic Yield of Computed Tomography-Guided Transthoracic Lung Biopsy in Diffuse Lung Diseases

“…Even in cases of fibrosing DLD, with a UIP or UIP-like HRCT pattern, in which the differential diagnosis is more problematic, TBLC has also provided a good diagnostic yield [12]. Few data are available on the role of CT-guided transthoracic lung biopsy for the diagnosis of DLD, and reports almost only refer to its role in OP, in which the technique has been used for diagnosis in isolated cases [40][41][42]. The procedure was also reported in a small cohort of patients for the diagnosis of PPFE and was considered a valuable tool in this context [43].…”