and Maurizio Dottorini1
1Pulmonary and Respiratory Intensive Care
Unit, S.M della Misericordia Hospital, Perugia, Italy
The fluoroscopy-guided transbronchial lung biopsy (TBLB) is an useful
technique for diagnosis of peripheral lung lesion (PLL). The diagnostic
yield of TBLB is limited and variable, ranging in literature from
16-80%. Nowadays the specimens collected must be suitable for tumor
genotyping and the published data for this issue are not conclusive.
of the study was to evaluate the diagnostic yield of fluoroscopy guided
TBLB and the adequacy of sample for molecular testing in adenocarcinoma
The pts. referred to our Unit in the period 2013-2015 due to peripheral
lung opacities with diameter ≥ 2 cm were included in the study.
We excluded pts with uncontrolled coagulopathy, pregnancy, emodinamic
the pts underwent bronchoscopy and fluoroscopy-guided TBLB and TB
needle aspiration (TBNA). We performed 4-6 TBLB and 4-6 TBNA for each
patient. In case of histopathologic diagnosis of adenocarcinoma,
genotyping for EGFR, ALK, K-RAS was done.
263 patients have been included, 164 males, age 68.811,
range 33-88 yrs. TBNA and TBLB allow a diagnosis in 167 patients
(diagnostic yield 68%)(table
1); the false negative were 48 (18.2%). The adenocarcinoma
represented the 40% of malignant lesions: in this group the sample was
adequate for genotyping examination in the majority of cases (>
The fluoroscopy-guided TBLB allowed a correct diagnosis in about 70% of
cases with very few adverse events. The specimen resulted adequate for
genotyping of adenocarcinoma in the majority of patients.
Source : http://erj.ersjournals.com/content/48/suppl_60/PA4681