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The contribution of CT-guided transthoracic lung biopsy to the diagnosis of organising pneumonia - 21/09/10

Doi : 10.1016/j.rmr.2009.12.002 
F. Metzger a, D. Pernet a, P. Manzoni b, E. Ranfaing c, J.-C. Dalphin a,
a Chest Clinic, Jean Minjoz University Hospital, 25000 Besançon, France 
b Radiology Department C, Saint Jacques University Hospital, 25000 Besançon, France 
c Pathology Lab, Jean Minjoz University Hospital, 25000 Besançon, France 

Corresponding author. Service de pneumologie, pôle cœur-poumons, CHU Jean-Minjoz, 2, boulevard Alexandre-Fleming, 25030 Besançon cedex, France.

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Summary

Background

Organising pneumonia is a pulmonary disease with variable clinical and radiological features and with many differential diagnoses. Diagnosis is based on histology obtained by either transbronchial or surgical lung biopsy but these techniques have several disadvantages. The aim of this study was to evaluate the diagnostic yield of CT-guided transthoracic lung biopsy in organising pneumonia and to compare it to the usual diagnostic tools.

Methods

Six cases of organising pneumonia diagnosed with CT-guided lung biopsy are reported and discussed. The role of CT-guided lung biopsy in the diagnosis of organising pneumonia was also reviewed in the literature.

Results

CT-guided transthoracic lung biopsies provided a higher rate of adequate samples than transbronchial biopsies (92–100% versus 77–86%). The samples were larger, which reduced the risks of misdiagnosis and increased the diagnostic yield (88–97% versus 26–55% in pulmonary nodules and 42–100% versus 66–75% in diffuse pulmonary disease). Complications were rare and generally not serious.

Conclusion

CT-guided transthoracic lung biopsy may be considered in place of transbronchial biopsy in the diagnosis of organising pneumonia. Surgical lung biopsy remains the gold standard method for diagnosis.

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Keywords : Bronchiolitis obliterans organising pneumonia, BOOP, Diagnostic techniques and procedures, Needle biopsy, Computed tomography scanner


Esquema


 To cite the present paper, use exclusively the following reference: Metzger F, Pernet D, Manzoni P, Ranfaing E, Dalphin J.-C. Apport de la biopsie pulmonaire transthoracique dans le diagnostic de pneumonie organisée. Rev Mal Respir 2008;25:539–50, doi:RMR-05-2008-25-5-0761-8425-101019-200804619 [full text in english on rmr].


© 2010  SPLF. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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