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The Egyptian Journal of Bronchology
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Diagnostic yield of fiber optic bronchoscopy in alveolar and/or ground glass opacification in chest computed tomographic scan

Egyptian Journal of Bronchology volume 12, pages 413–418 (2018)Cite this article

Abstract

Background and objective

Transbronchial lung biopsy (TBLB) can be obtained using forceps and usually represents the centrilobular regions. Therefore, disorders that are centered around terminal and respiratory bronchioles or distributed along the lymphatic routes can be diagnosed. This study investigated the diagnostic yield of flexible bronchoscopy in patients with ground-glass opacity (GGO) or alveolar filling for histopathological diagnosis and found out its complications.

Patients and methods

Twenty-six patients with predominant GGO or alveolar opacity in the chest computed tomographic (CT) scan were submitted for TBLB for histopathological confirmation. Patients with respiratory failure, heart failure, coagulopathy, or pathognomonic CT patterns were excluded. All patients were subjected to full history taking, chest CT scan, and TBLB with histopathological examination of the specimens.

Results

The diagnostic yield of TBLB was 73.1%. Histopathological diagnoses included hypersensitivity pneumonitis (23.1%), sarcoidosis (19.2%), adenocarcinoma (11.5%), small cell lung cancer (7.7%), alveolar proteinosis (3.8%), alveolar hemorrhage (3.8%), organizing pneumonia (3.8%), and chronic nonspecific inflammation (26.9%). There was no significant correlation between age, sex, smoking, and histopathological diagnoses. Regarding the predominant CT finding, 15 (57.7%) patients had GGO, whereas 11 (42.3%) patients had alveolar filling with significant (P=0.008) positive correlation between the CT predominant pattern and histopathological diagnoses. There was a positive significant correlation between lymph node enlargement in CT and histopathological diagnosis (P=0.029). Complications from TBLB included the pneumothorax (15.4%) and bleeding (7.7%).

Conclusions

TBLB seems to be a useful and safe procedure. It is of a high diagnostic value. Therefore, it could be considered a routine diagnostic procedure before thoracoscopic or open lung biopsy.

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Authors and Affiliations

  1. Department of Pulmonology, Faculty of Medicine, Cairo University, 10 Gomaa Saleh Street, 1456, Helwan, Cairo, Egypt

    Hoda A. A. Youssef, Marwa M. Shaban & Sabah A. Mohamed MD

  2. Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt

    Hany M. Khattab

  3. Department of Pulmonology, National Institute of Chest Diseases and Allergy, Imbaba, Egypt

    Khaled M. Mostafa

Authors
  1. Hoda A. A. Youssef
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  2. Hany M. Khattab
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  3. Marwa M. Shaban
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  4. Sabah A. Mohamed MD
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  5. Khaled M. Mostafa
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Corresponding author

Correspondence to Sabah A. Mohamed MD.

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Youssef, H.A.A., Khattab, H.M., Shaban, M.M. et al. Diagnostic yield of fiber optic bronchoscopy in alveolar and/or ground glass opacification in chest computed tomographic scan. Egypt J Bronchol 12, 413–418 (2018). https://doi.org/10.4103/ejb.ejb_16_18

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  • DOI: https://doi.org/10.4103/ejb.ejb_16_18

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