Our Summary

This study looked at a type of lung biopsy called transbronchial lung biopsy (TBLB) to figure out how effective it is at diagnosing lung diseases from bacteria and fungi, especially when a newer tool, endobronchial ultrasonography with a guide-sheath (EBUS-GS), is used. To do this, they looked back at 31 patients who had this kind of biopsy done at Fukujuji Hospital between 2018 and 2022.

The patients had a range of lung diseases, including non-tuberculous mycobacteriosis, pulmonary aspergillosis, lung abscess, and pulmonary tuberculosis. The researchers compared the results of the biopsies to the results of a different kind of test where they wash the bronchial area and the device used in the biopsy.

They found that the biopsies did not diagnose as many diseases as the washing test did (only about 36% compared to 65%). There was only one patient whose disease was found by the biopsy and not by the washing test.

When they looked specifically at diseases caused by mycobacteria, there was no significant difference between how often the biopsy and the washing test found the disease. But, the washing test diagnosed more diseases overall in patients with mycobacteria than in those with diseases caused by other microbes.

In conclusion, the researchers suggest that even with the use of the newer EBUS-GS tool, TBLB biopsies might not be very helpful in diagnosing lung diseases caused by infections.

FAQs

  1. What is transbronchial lung biopsy (TBLB) and how is it used in diagnosing lung diseases?
  2. How does the effectiveness of TBLB biopsies compare to the washing test in diagnosing lung diseases?
  3. Did the use of the newer EBUS-GS tool improve the effectiveness of TBLB biopsies in diagnosing lung diseases caused by infections?

Doctor’s Tip

A doctor might advise a patient undergoing a lung biopsy to discuss alternative diagnostic tests, such as bronchial washing, with their healthcare provider to ensure the most accurate diagnosis possible. It’s important to have a thorough discussion about the benefits and limitations of different testing methods to determine the best course of action for your specific situation.

Suitable For

Patients who are typically recommended lung biopsy include those with suspected lung cancer, interstitial lung disease, infections such as tuberculosis or fungal infections, and other lung conditions that are difficult to diagnose based on imaging or other tests. In this study, patients with non-tuberculous mycobacteriosis, pulmonary aspergillosis, lung abscess, and pulmonary tuberculosis were recommended for lung biopsy to help diagnose their specific lung diseases.

Timeline

Timeline of a patient’s experience before and after a lung biopsy:

Before the lung biopsy:

  1. Patient presents with symptoms such as coughing, shortness of breath, chest pain, or abnormal lung imaging.
  2. Patient undergoes preliminary tests such as chest X-rays, CT scans, or bronchoscopy to assess the lung condition.
  3. After discussion with the healthcare provider, a decision is made to proceed with a lung biopsy for further diagnosis.
  4. Patient is informed about the procedure, risks, and benefits, and any necessary preparations are made.

During the lung biopsy:

  1. Patient is given anesthesia or sedation to minimize discomfort during the procedure.
  2. The biopsy is performed using a bronchoscope, guided by imaging tools such as EBUS-GS in some cases.
  3. Tissue samples are collected from the lung for further analysis.

After the lung biopsy:

  1. Patient is monitored for any immediate complications such as bleeding, infection, or breathing difficulties.
  2. Tissue samples are sent to a pathology lab for analysis to determine the presence of any infections, tumors, or other abnormalities.
  3. Patient may experience mild discomfort, coughing, or slight bleeding at the biopsy site, which usually resolves within a few days.
  4. Results of the biopsy are discussed with the patient, and further treatment plans are made based on the findings.
  5. Follow-up appointments may be scheduled to monitor the patient’s recovery and response to treatment.

What to Ask Your Doctor

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

  1. What type of lung biopsy procedure will be performed?
  2. What are the risks and potential complications associated with the biopsy procedure?
  3. How will the biopsy results help in diagnosing my lung condition?
  4. Are there alternative diagnostic tests or procedures that could be considered instead of a biopsy?
  5. What is the experience of the medical team performing the biopsy procedure?
  6. How long will it take to receive the biopsy results?
  7. Will I need any follow-up appointments or treatments based on the biopsy results?
  8. How should I prepare for the biopsy procedure, including any necessary fasting or medication adjustments?
  9. What type of anesthesia or sedation will be used during the biopsy procedure?
  10. Are there any specific instructions to follow after the biopsy procedure to promote healing and reduce the risk of complications?

Reference

Authors: Shimoda M, Morimoto K, Tanaka Y, Ito M, Moue I, Yoshimori K, Ohta K. Journal: Sci Rep. 2023 Sep 26;13(1):16128. doi: 10.1038/s41598-023-43078-x. PMID: 37752193