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Management and utility of transbronchial lung cryobiopsy in Japan
Authors:Naoyuki Kuse  Minoru Inomata  Nobuyasu Awano  Hanako Yoshimura  Tatsunori Jo  Mari Tone  Atsuko Moriya  Yuan Bae  Toshio Kumasaka  Tamiko Takemura  Takehiro Izumo
Affiliation:1. Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8953, Japan;2. Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8953, Japan
Abstract:BackgroundTransbronchial lung cryobiopsy (TBLC), which is transbronchial lung biopsy performed using a cryoprobe, has emerged as a new method for obtaining lung tissue specimens for diagnosing pulmonary diseases. TBLC has been widely performed, and many reports have documented its safety and feasibility in diagnosing pulmonary diseases such as lung cancer and diffuse parenchymal lung disease. However, to date, no reports have yet been published from Japan. Therefore, the purpose of this study was to describe our experience with TBLC in daily practice in Japan and compare it with those reported in previous studies from other countries. We also evaluated the efficacy and feasibility of TBLC.MethodsWe retrospectively evaluated the clinical records of 50 consecutive patients who had undergone TBLC between November 2017 and May 2018 at the Japanese Red Cross Medical Center. Demographic data, procedure details, and the diagnostic yield were analyzed.ResultsWe analyzed the records of 50 patients who underwent diagnostic TBLC. Their median age was 71 years, and they included 34 men (68%). The median maximal diameter of the cryobiopsy specimens was 5.3 mm (range, 2.0–23.0 mm), and the median area of the cryobiopsy specimens was 15.5 mm2 (range, 3.0–136.5 mm2). The rate of obtaining adequate specimens was 91%, and the pathological diagnostic yield was 76%. No complications were observed, except for one case of pneumonia.ConclusionsThis is the first report from Japan analyzing the efficacy and feasibility of TBLC in daily clinical practice. TBLC was considered efficacious, safe, and feasible for Japanese patients with various lung diseases.
Keywords:DPLD  diffuse parenchymal lung disease  EBUS  endobronchial ultrasonography  HP  hypersensitivity pneumonitis  MDD  multidisciplinary discussion  OP  organizing pneumonia  SLB  surgical lung biopsy  TBLC  transbronchial lung cryobiopsy  Transbronchial lung cryobiopsy  Endobronchial ultrasonography  Diffuse parenchymal lung disease  Lung cancer
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