Our Summary

This research paper is about the role of lung biopsy (LBx) in predicting the prognosis (outcome) of interstitial lung diseases (ILDs) - diseases that affect the tissue and space around the air sacs of the lungs.

The researchers analyzed the LBx results of 426 patients with ILDs. These patients were divided into two groups: those who underwent transbronial lung cryobiopsy (TBLC), a less invasive procedure, and those who had a surgical lung biopsy (SLB).

Before and after the LBx, a team of medical professionals made a diagnosis and determined a treatment strategy. They found that the LBx results caused them to change the treatment strategy in about one-third of the cases.

They also found that the LBx results led to a change in diagnosis for some patients. This reclassification significantly affected the patient’s prognosis. For instance, patients initially diagnosed as non-idiopathic pulmonary fibrosis (non-IPF), but later reclassified as IPF after LBx, had a worse survival rate compared to those who remained classified as non-IPF. Conversely, patients initially diagnosed as IPF, but later reclassified as non-IPF after LBx, had a better prognosis compared to confirmed IPF cases.

In simpler terms, performing a lung biopsy can provide more accurate information about the patient’s lung disease, which can lead to changes in diagnosis and treatment strategy, ultimately impacting the patient’s prognosis.

FAQs

  1. What is the role of lung biopsy (LBx) in predicting the prognosis of interstitial lung diseases (ILDs)?
  2. How does a lung biopsy affect the diagnosis and treatment strategy in patients with ILDs?
  3. Why does a change in diagnosis after lung biopsy have a significant impact on the patient’s prognosis?

Doctor’s Tip

One tip a doctor might tell a patient about lung biopsy is to follow any pre-procedure instructions carefully, such as fasting before the procedure or stopping certain medications. This will help ensure the biopsy is successful and accurate. Additionally, it’s important to discuss any concerns or questions with your healthcare provider before the procedure to alleviate any anxiety or confusion. Finally, after the biopsy, it’s important to follow post-procedure instructions for proper care and monitoring to ensure a smooth recovery.

Suitable For

Patients who are typically recommended for a lung biopsy include those with suspected ILDs, particularly those with unclear or atypical presentations, progression of disease despite treatment, or those who are not responding to initial treatments. Additionally, patients who may benefit from a lung biopsy are those with suspected lung cancer, suspected infections, or those with unexplained lung nodules or masses. Ultimately, the decision to recommend a lung biopsy is made by the healthcare team based on the individual patient’s clinical presentation, imaging findings, and overall health status.

Timeline

Before the lung biopsy:

  1. The patient undergoes a physical examination and medical history review.
  2. Imaging tests such as chest X-rays, CT scans, or MRI scans are performed to identify the abnormality in the lungs.
  3. Pulmonary function tests may be conducted to assess lung function.
  4. The patient may undergo bronchoscopy to collect samples of lung tissue or fluids.
  5. A multidisciplinary team of medical professionals reviews the patient’s case and decides on the need for a lung biopsy.

After the lung biopsy:

  1. The patient undergoes the lung biopsy procedure, either TBLC or SLB, under sedation or general anesthesia.
  2. After the procedure, the patient is monitored for any complications such as bleeding or infection.
  3. The collected tissue samples are sent to a pathologist for analysis.
  4. The pathologist provides a diagnosis based on the biopsy results.
  5. The medical team reviews the diagnosis and treatment strategy based on the biopsy findings.
  6. Changes may be made to the initial diagnosis or treatment plan based on the biopsy results.
  7. The patient is monitored for any changes in symptoms or lung function following the biopsy.
  8. The biopsy results may impact the patient’s prognosis and guide further management of the lung disease.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung biopsy include:

  1. Why do I need a lung biopsy, and what information will it provide about my condition?
  2. What are the different types of lung biopsy procedures available, and which one is most suitable for my case?
  3. What are the potential risks and complications associated with the lung biopsy procedure?
  4. How should I prepare for the lung biopsy, and what can I expect during and after the procedure?
  5. How soon will I receive the results of the lung biopsy, and how will they impact my diagnosis and treatment plan?
  6. Will the lung biopsy results change my prognosis or affect my long-term outcome?
  7. Are there any alternative tests or procedures that can provide similar information without the need for a lung biopsy?
  8. Will I need any additional follow-up appointments or treatments based on the results of the lung biopsy?
  9. Can I get a second opinion on the need for a lung biopsy or the interpretation of the results?
  10. Is there anything else I should know or consider before undergoing a lung biopsy?

Reference

Authors: Tomassetti S, Ravaglia C, Puglisi S, Ryu JH, Colby TV, Cavazza A, Wells AU, Pavone M, Vancheri C, Lavorini F, Matucci-Cerinic M, Rosi E, Luzzi V, Gori L, Rossi G, Donati L, Dubini A, Piciucchi S, Poletti V. Journal: Ann Am Thorac Soc. 2022 May;19(5):737-745. doi: 10.1513/AnnalsATS.202104-466OC. PMID: 34739359