Our Summary

Respiratory diseases cause a significant amount of illness and death worldwide. Currently, the best method for diagnosing these diseases is through histopathology, a method involving the microscopic examination of tissues. However, cytology, the study of individual cells, is also useful for a quick diagnosis. In this study, researchers evaluated various cytology techniques, including bronchoalveolar lavage (BAL), brush cytology, and imprint smears, to diagnose visible and non-visible lesions in the lungs. They compared these methods with the results from a transbronchial lung biopsy, a type of tissue sampling.

The study found that for diagnosing cancer, the most consistent results were seen with imprint cytology, followed by BAL and brush cytology. However, for non-cancerous diseases, the agreement between cytology and biopsy was not good. The agreement improved when BAL and imprint smears were used together.

Therefore, the researchers recommend using a combination of cytology techniques for suspected cases of lung cancer. They also suggest that all cases should include imprint smears. Despite these findings, biopsy is still considered the best method for diagnosing non-cancerous lung diseases.

FAQs

  1. What is the best method for diagnosing respiratory diseases?
  2. Which cytology techniques were evaluated in the study for diagnosing lung diseases?
  3. What do researchers recommend for diagnosing suspected cases of lung cancer?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lung biopsy is to make sure to follow all pre-biopsy instructions given by the healthcare team, such as fasting before the procedure and any specific medication guidelines. It is also important to inform the healthcare team about any allergies or medical conditions before the biopsy. After the procedure, it is normal to experience some discomfort or pain at the biopsy site, so it is important to follow post-biopsy care instructions provided by the healthcare team. Additionally, it is important to keep the biopsy site clean and dry to prevent infection. If any unusual symptoms occur after the biopsy, such as excessive bleeding or signs of infection, it is important to contact the healthcare team immediately.

Suitable For

Overall, patients who are typically recommended for lung biopsy include those with suspected lung cancer, suspected non-cancerous lung diseases such as interstitial lung disease or pulmonary fibrosis, suspected infections such as tuberculosis or fungal infections, suspected autoimmune diseases affecting the lungs, and suspected complications from other underlying medical conditions. Additionally, patients who have abnormal findings on imaging studies such as chest X-rays or CT scans may also be recommended for lung biopsy to further evaluate their condition.

Timeline

Before a lung biopsy:

  1. Patient presents with symptoms such as coughing, shortness of breath, chest pain, or coughing up blood.
  2. Patient undergoes initial evaluation, which may include a physical exam, imaging tests (such as chest X-ray or CT scan), and pulmonary function tests.
  3. Based on initial evaluation, a lung biopsy may be recommended to further investigate the cause of the symptoms.

After a lung biopsy:

  1. Patient undergoes the biopsy procedure, which may be done through bronchoscopy, needle biopsy, or surgical biopsy.
  2. After the biopsy, the patient may experience some discomfort or pain at the biopsy site.
  3. The biopsy sample is sent to the lab for analysis, which may take a few days to a week.
  4. Once the results are available, the patient meets with their healthcare provider to discuss the findings and determine the appropriate treatment plan.
  5. Treatment may involve medications, surgery, radiation therapy, or other interventions depending on the diagnosis.
  6. Follow-up appointments may be scheduled to monitor the patient’s progress and adjust the treatment plan as needed.

What to Ask Your Doctor

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

  1. Why is a lung biopsy necessary in my case?
  2. What are the risks and potential complications associated with a lung biopsy?
  3. How will the biopsy be performed?
  4. Will I need to stay in the hospital after the biopsy?
  5. How long will it take to get the results of the biopsy?
  6. What will the biopsy results tell us about my condition?
  7. Are there any alternative diagnostic tests or procedures that could be considered instead of a lung biopsy?
  8. Will I need any specific preparation before the biopsy?
  9. How should I expect to feel after the biopsy?
  10. What follow-up care or treatments may be necessary based on the biopsy results?

Reference

Authors: Jois DS, Mutreja D, Handa A, Moorchung N. Journal: Rev Esp Patol. 2020 Apr-Jun;53(2):75-78. doi: 10.1016/j.patol.2019.05.002. Epub 2019 Aug 22. PMID: 32199597