Utility of transbronchial cryobiopsy in diagnosis of diffuse interstitial lung disease

【摘要】：Objective To evaluate the efficiency of transbronchial lung cryobiopsy(TBCB)in diagnosis of diffuse interstitial lung disease(DILD). Methods A total of 20 patients with radiographic features of DILD underwent TBCB in Ningbo Medical Center Li Huili Hospital from June 2019 to April 2020.The results of clinical data,radiological and TBCB were retrospectively analyzed. Results A total of 20 patients(male 6 female 14,meanage(52 ±16) years, range 40 to 75 years)with inconclusive diagnosis of interstitial lung disease wre sequentially enrolled.5 patients under general anesthesia with rigid bronchoscopy and 15 patients under anesthesia with tracheal intubation. All the balloons were preset, and the frozen probe No. 19 was selected, and a suitable target site was selected for cryobiopsy. A total of 70 TBCB tissue samples were obtained with an average diameter of(4.5 ± 1.5) mm. 18 cases(90.O%) obtained a clear pathomorphological diagnosis, and the pathological type was 3 cases of organizing pneumonia(one of them considered related to lung cancer targeted therapy, and the other two considered cryptogenic organizing pneumonia), 3 cases of pulmonary alveolar proteinosis, one case of hypersensitivity,5 cases of idiopathic nonspecific interstitial pneumonia, 2 cases of asbestos-related interstitial lung disease, two cases of rheumatoid arthritis-related interstitial lung disease, one case of chronic eosinophil pneumonia, one case of usual interstitial pneumonia, and 2 cases of chronic inflammation disease, the diagnostic positive rate was 90.0%(18/20). The incidences of hemorrhage and pneumothorax were 50.0%(10/20) and 5%(1/20), respectively, and the amount of bleeding was small. One case had a bleeding volume of about 30 ml, and the bleeding stopped after hemostatic treatment. The drainage tube is placed in the pneumothorax and absorbed after drainage. Conclusion Transbr onchial crybiopsy has a high diagnosis rate for diffuse interstitial lung disease, less complications, and good safety. However, the sample size is small and needs to be further confirmed by large sample studies.