Our Summary

This study looked at complications from a less invasive alternative to surgical lung biopsy, called transbronchial lung cryobiopsy (TBC), used to diagnose interstitial lung disease (ILD). The researchers evaluated 90 patients with ILD who underwent TBC. They found that the most common complication was pneumothorax (a collapsed lung), which occurred in 22 patients. Of these, 18 required chest tube drainage. They also observed significant bleeding in 13 patients.

The researchers found that the risk of pneumothorax was about 10 times higher if the pleura (the membrane lining the lungs) was present in the biopsy samples. They also found that the risk of bleeding increased with each unit increase in body mass index (BMI). The researchers conclude that more studies are needed to better understand the complications of TBC and improve patient selection for this procedure.

FAQs

  1. What is the most common complication of transbronchial lung cryobiopsy (TBC) in diagnosing interstitial lung disease (ILD)?
  2. How does the presence of the pleura in biopsy samples affect the risk of pneumothorax in TBC?
  3. How does a patient’s body mass index (BMI) influence the risk of bleeding during a TBC procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung biopsy is to discuss any potential risks and complications beforehand. This can include the risk of pneumothorax, bleeding, infection, and other complications. It’s also important for the patient to follow any pre-procedure instructions given by their healthcare provider, such as fasting or stopping certain medications. Additionally, the doctor may recommend taking it easy for a period of time after the procedure to allow for proper healing. It’s important for the patient to communicate any concerns or symptoms they may experience after the biopsy to their healthcare provider.

Suitable For

Patients who are typically recommended for lung biopsy include those with suspected lung cancer, suspected interstitial lung disease (such as idiopathic pulmonary fibrosis), suspected infections (such as tuberculosis or fungal infections), suspected sarcoidosis, suspected metastatic disease to the lungs, or suspected granulomatous disease. Additionally, patients with unexplained lung nodules or masses, unexplained pleural effusions, or unexplained lung infiltrates may also be recommended for a lung biopsy to help determine the underlying cause of their symptoms.

Timeline

Before the lung biopsy:

  1. Patient presents with symptoms of interstitial lung disease, such as shortness of breath, cough, and fatigue.
  2. Patient undergoes various diagnostic tests, such as chest X-rays, CT scans, and pulmonary function tests to evaluate the extent of lung involvement.
  3. After consultation with a pulmonologist, a decision is made to proceed with a lung biopsy to obtain a tissue sample for diagnosis.
  4. Patient undergoes pre-procedural evaluations, such as blood tests and imaging studies, to assess their overall health and suitability for the procedure.

During and immediately after the lung biopsy:

  1. Patient is prepped and given sedation or anesthesia for the procedure.
  2. A bronchoscope is inserted through the mouth or nose and guided to the lung lesion.
  3. Tissue samples are obtained using a cryotherapy probe, which freezes and extracts small pieces of lung tissue.
  4. The procedure may take up to an hour, depending on the number of samples needed.
  5. Patient is monitored for any immediate complications, such as bleeding or pneumothorax.
  6. Chest X-ray may be performed to check for any post-procedural complications.

After the lung biopsy:

  1. Patient is monitored for several hours to ensure stability and absence of complications.
  2. Patient may experience some discomfort, sore throat, or coughing up blood for a few days after the procedure.
  3. Results of the biopsy are sent to a pathologist for analysis, which may take a few days to a week.
  4. Once the diagnosis is confirmed, the pulmonologist will discuss treatment options and follow-up care with the patient.
  5. Patient may be advised to avoid strenuous activities and heavy lifting for a few days after the procedure.
  6. Follow-up appointments are scheduled to monitor the patient’s recovery and response to treatment.

What to Ask Your Doctor

  1. What are the potential risks and complications of a lung biopsy, specifically a transbronchial lung cryobiopsy (TBC)?

  2. How likely am I to experience complications such as pneumothorax or significant bleeding during or after the procedure?

  3. Are there any factors, such as the presence of pleura in the biopsy samples or my BMI, that may increase my risk of complications?

  4. How will the risk of complications be managed during the procedure and afterwards?

  5. What steps can be taken to minimize the risk of complications during a lung biopsy?

  6. What is the recovery process like after a lung biopsy, and what should I expect in terms of pain, discomfort, and potential complications?

  7. Are there any alternative diagnostic tests or procedures that could be considered instead of a lung biopsy?

  8. How will the results of the biopsy be used to diagnose and treat my condition, and what are the potential benefits of undergoing this procedure?

  9. What are the long-term implications of undergoing a lung biopsy, and how will it impact my overall health and treatment plan?

  10. Are there any specific instructions or precautions I should follow before and after the procedure to reduce the risk of complications and promote a successful recovery?

Reference

Authors: Linhas R, Marçôa R, Oliveira A, Almeida J, Neves S, Campainha S. Journal: Rev Port Pneumol (2006). 2017 Nov-Dec;23(6):331-337. doi: 10.1016/j.rppnen.2017.07.001. Epub 2017 Aug 9. PMID: 28800873