ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Surgical lung biopsy for differential diagnosis of interstitial lung disease
Tülin Sevim1, Fatma Tokgöz Akyıl1, Hakan Kıral2, Emine Aksoy1, Mustafa Akyıl2, Mustafa Vayvada2, Ayçim Şen3, Çağatay Tezel2, Volkan Baysungur2
1Departments of Chest Diseases, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
2Departments of Thoracic Surgery, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
Departments of Pathology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2016.12399
Background: This study aims to investigate the diagnostic yield of surgical lung biopsy for the differential diagnosis of interstitial lung disease and the factors affecting diagnosis.

Methods: We retrospectively reviewed medical records of 202 patients (91 males, 111 females; mean age 49±12 years; range 18 to 78 years) who underwent surgical lung biopsy in our hospital between May 2008 and December 2014. We recorded patients’ demographic characteristics, surgery type, number and localization of biopsies, and final diagnoses established in light of histopathological findings. According to the final diagnoses, we divided patients into two groups as patients with an established specific diagnosis (group 1) and patients without an established specific diagnosis (group 2). We investigated the effect of surgical procedure on final diagnosis.

Results: Left lung was more frequently sampled (72%) and 75% of the procedures ended up with a single biopsy. Total number of biopsies was 255. Of all samples, 44% were taken from the middle lobe or lingula. Rate of patients with a histopathologically established and clinically and radiologically verified final diagnosis was 80% (group 1). Gender (p=0.161), number of samples (p=0.541), lung side (p=0.954), or lung segment (p=0.592) did not affect the rate of establishing a diagnosis. Of the patients, mortality was observed in 2%, major complications in 1.5%, and minor complications in 9.5%. No relationship was detected between localization or number of biopsies and development of complications (p>0.05).

Conclusion: Albeit with low probability, surgical lung biopsies are correlated with morbidity and mortality. Not all procedures result in a specific diagnosis. Localization, type or number of biopsies do not affect the diagnosis rate significantly.

Keywords : Idiopathic interstitial pneumonia; idiopathic pulmonary fibrosis; non-specific interstitial pneumonia
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