High short-term mortality following lung biopsy for usual interstitial pneumonia

Abstract

Usual interstitial pneumonia (UIP) is a specific histological pattern of interstitial pneumonia most often associated with the clinical syndrome of idiopathic pulmonary fibrosis (IPF). There is controversy regarding the use of surgical lung biopsy in the diagnosis of UIP, and the risk of lung biopsy in these patients is largely unknown. This study investigated the 30 day surgical mortality rate in patients undergoing surgical lung biopsy for UIP.Patients undergoing surgical lung biopsy over a 10-yr period from 1986–1995 with the ultimate diagnosis of UIP (with or without underlying connective tissue disease) were identified. Pathology, computed tomography, medical records, and survival were assessed.Ten of sixty patients with usual interstitial pneumonia were found to be dead within 30 days of surgical biopsy. All of these were patients with idiopathic UIP, unassociated with connective tissue disease (clinical condition of IPF).In conclusion, patients with usual interstitial pneumonia of the idiopathic type, who present with atypical features, may be at higher risk for death following surgical biopsy than patients presenting with more typical features or patients with other interstitial illnesses.

Preclinical SPECT/CT Imaging of αvβ6 Integrins for Molecular Stratification of Idiopathic Pulmonary Fibrosis

“…Lung biopsies are not universally performed and in the current American Thoracic Society/ European Respiratory Society consensus statement are recommended only for discrimination of probable and possible IPF (7). As discussed earlier, lung biopsies suffer from sampling bias, leading to suboptimal quantification, and furthermore, given the significant mortality rate associated with lung biopsies, repeated sampling is impractical (44). Therefore, molecular imaging using SPECT/CT is likely to offer a significant advance for immunophenotyping patients with IPF that would not otherwise be possible.…”

Surgical lung biopsy for the diagnosis of interstitial lung disease in England: 1997–2008

“…Case series have reported 30-day mortality rates of around 1.5-4.5%, although these may be biased by careful case selection or local expertise and are not necessarily generalisable to other centres [4][5][6][7]. Other case series note much higher mortality rates [8,9].…”

Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis

“…It may be associated with significant morbidity (2-20%), including prolonged air leak and prolonged hospital admission, and mortality (2-17%). [17][18][19][20][21][22][23] Transbronchial lung biopsy can also be performed using cryoprobes, termed cryo-transbronchial lung biopsy. 24 Cryotherapy works on the principle of the Joule-Thomson effect, wherein the adiabatic expansion of a compressed gas leads to rapid cooling.…”