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The role of medical thoracoscopic lung biopsy in diagnosis of diffuse parenchymal lung diseases

Egyptian Journal of Bronchology volume 13, pages 155–161 (2019)Cite this article

Abstract

Background

Interstitial lung disease in the immunocompetent patient is often a difficult challenge for the clinician, especially when no diagnostic clues are present. A clear diagnosis confirmed by biopsy allows clinicians and patients to discuss fully the implications of the disease.

Aim

The aim was to evaluate the role of medical thoracoscopic lung biopsy in diagnosis of patients with diffuse parenchymal lung diseases.

Patients and methods

The study included 15 patients with diffuse parenchymal lung diseases of unknown etiology. They had undergone full history taking, complete clinical examination, ventilatory function tests (spirometry), arterial blood gases analysis, high-resolution computed tomography chest, coagulation profile, platelet count, collagen profile, and thoracoscopic lung biopsy by medical thoracoscopy for histopathologic examination. Follow-up of the patients in the inpatient unit was done by chest radiography and clinical evaluation.

Results

The pathological diagnosis of cases was six (40%) patients with extrinsic allergic alveolitis, five (33.3%) patients with malignancy, three patients with idiopathic interstitial pneumonias, one (6.7%) patient with tuberculosis, and one (6.7%) patient with sarcoidosis. Regarding complications, one (6.7%) patient had pneumothorax after intercostal tube (ICT) removal, and three (20%) patients had subcutaneous emphysema. The duration of the ICT drainage was 3.1±2.6 days. There was no wound infection, no bleeding, no persistent air leak after more than 24 h (Hs) from ICT insertion, no respiratory failure requiring ICU admission, and no mortality in the study sample.

Conclusion

Thoracoscopic lung biopsy by medical thoracoscopy is useful in diagnosis of cases with diffuse parenchymal lung diseases of unknown etiology when lung biopsy is needed for accurate diagnosis. The procedure is safe. The procedure carries some complications that are not life threatening and can be minimized by good selection of patients.

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Authors and Affiliations

  1. Department of Chest Diseases, Banha University, 13511, Banha, Egypt

    Magdy M. Omar, Mohammad A. E. El-Mahdy & Etemad Abdelsalam MBBCH, MSC, MD chest (Lecturer of Chest Diseases and Tuberculosis)

  2. Faculty of Medicine, Banha University, Banha, Egypt

    Ahmad S. Alhalafawy

  3. Department of Chest Diseases, Faculty of Medicine, Cairo University, Cairo, Egypt

    Nashwa M. Emara

Authors
  1. Magdy M. Omar
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  2. Ahmad S. Alhalafawy
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  3. Nashwa M. Emara
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  4. Mohammad A. E. El-Mahdy
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  5. Etemad Abdelsalam MBBCH, MSC, MD chest
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Corresponding author

Correspondence to Etemad Abdelsalam MBBCH, MSC, MD chest.

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Omar, M.M., Alhalafawy, A.S., Emara, N.M. et al. The role of medical thoracoscopic lung biopsy in diagnosis of diffuse parenchymal lung diseases. Egypt J Bronchol 13, 155–161 (2019). https://doi.org/10.4103/ejb.ejb_41_18

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  • DOI: https://doi.org/10.4103/ejb.ejb_41_18

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