Report Standardization in Transbronchial Lung Cryobiopsy

Ravaglia, Claudia; Rossi, Giulio; Tomassetti, Sara; Dubini, Alessandra; Piciucchi, Sara; Chilosi, Marco; Cavazza, Alberto; Bendstrup, Elisabeth; Kronborg-White, Sissel; Folkersen, Birgitte Holst; Colella, Sara; Madsen, Line Bille; Poletti, Venerino

doi:10.5858/arpa.2018-0438-le

Cited by 11 publications

(9 citation statements)

References 6 publications

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“…The pathologist should analyze the TLCB specimens using the same criteria as those accepted for specimens obtained from SLB. The international increase in the use of TLCB calls for a precise standardization of the analytical and reporting methods used by pathologists for the specimens obtained with TLCB [37]. Romagnoli et al highlight a low correlation between the two procedures [38].…”

Section: Discussionmentioning

confidence: 99%

Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure

et al. 2019

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Introduction: Transbronchial cryobiopsy is an alternative to surgical biopsy for the diagnosis of fibrosing interstitial lung diseases, although the role of this relatively new method is rather controversial. Aim of this study is to evaluate the diagnostic performance and the safety of transbronchial cryobiopsy in patients with fibrosing interstitial lung disease. Materials and methods: The population in this study included patients with interstitial lung diseases who underwent cryobiopsy from May 2015 to May 2018 at the Division of Pneumology of San Giuseppe Hospital in Milan and who were retrospectively studied. All cryobiopsy procedures were performed under fluoroscopic guidance using a flexible video bronchoscope and an endobronchial blocking system in the operating room with patients under general anaesthesia. The diagnostic performance and safety of the procedure were assessed. The main complications evaluated were endobronchial bleeding and pneumothorax. All cases were studied with a multidisciplinary approach, before and after cryobiopsy. Results: Seventy-three patients were admitted to this study. A specific diagnosis was reached in 64 cases, with a diagnostic sensitivity of 88%; 5 cases (7%) were considered inadequate, 4 cases (5%) were found to be non-diagnostic. Only one major bleeding event occurred (1.4%), while 14 patients (19%) experienced mild/moderate bleeding events while undergoing bronchoscopy; 8 cases of pneumothorax (10.9%) were reported, of which 2 (2.7%) required surgical drainage. Conclusions: When performed under safe conditions and in an experienced center, cryobiopsy is a procedure with limited complications having a high diagnostic yield in fibrotic interstitial lung disease.

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Section: Discussionmentioning

confidence: 99%

Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure

et al. 2019

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“…Adequacy was evaluated by considering dimensions of the samples (mm on both axes), surface area (mm 2 ) and percentage of lung parenchyma present in each biopsy (at least 30%) [ 21 ]. Adequate samples were classified as centrally sampled when predominant bronchi with cartilage plates or bronchiolar structures were seen in more than 40% of surface or peripherally sampled when alveoli were present in at least 60% of surface with or without visceral pleura [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Fibrotic progression and radiologic correlation in matched lung samples from COVID-19 post-mortems

et al. 2020

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Data on the pathology of COVID-19 are scarce; available studies show diffuse alveolar damage; however, there is scarce information on the chronologic evolution of COVID-19 lung lesions. The primary aim of the study is to describe the chronology of lung pathologic changes in COVID-19 by using a post-mortem transbronchial lung cryobiopsy approach. Our secondary aim is to correlate the histologic findings with computed tomography patterns. SARS-CoV-2-positive patients, who died while intubated and mechanically ventilated, were enrolled. The procedure was performed 30 min after death, and all lung lobes sampled. Histopathologic analysis was performed on thirty-nine adequate samples from eight patients: two patients (illness duration < 14 days) showed early/exudative phase diffuse alveolar damage, while the remaining 6 patients (median illness duration—32 days) showed progressive histologic patterns (3 with mid/proliferative phase; 3 with late/fibrotic phase diffuse alveolar damage, one of which with honeycombing). Immunohistochemistry for SARS-CoV-2 nucleocapsid protein was positive predominantly in early-phase lesions. Histologic patterns and tomography categories were correlated: early/exudative phase was associated with ground-glass opacity, mid/proliferative lesions with crazy paving, while late/fibrous phase correlated with the consolidation pattern, more frequently seen in the lower/middle lobes. This study uses an innovative cryobiopsy approach for the post-mortem sampling of lung tissues from COVID-19 patients demonstrating the progression of fibrosis in time and correlation with computed tomography features. These findings may prove to be useful in the correct staging of disease, and this could have implications for treatment and patient follow-up.

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“…However, the criteria for making this judgment are not specified. Also, the localization of the biopsy site (i.e., central/peribronchial or peripheral) is not reported, and neither is the presence of pleura in the biopsy, a sign that shows that the biopsy is from the peripheral compartments of the lung (4). The pneumothorax rate of 9.5% was low, which also indicates that biopsies were taken from more central lung compartments.…”

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confidence: 99%

Surgical Lung Biopsy and Cryobiopsy in Fibrosing Interstitial Lung Diseases: One Swallow Does Not Make a Summer

Bendstrup

Kronborg-White

Madsen

et al. 2019

Am J Respir Crit Care Med

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Report Standardization in Transbronchial Lung Cryobiopsy

Cited by 11 publications

References 6 publications

Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure

Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure

Fibrotic progression and radiologic correlation in matched lung samples from COVID-19 post-mortems

Surgical Lung Biopsy and Cryobiopsy in Fibrosing Interstitial Lung Diseases: One Swallow Does Not Make a Summer

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