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Perhimpunan Dokter Paru Indonesia - Diagnostic yield of fluoroscopy-guided transbronchial biopsy in peripheral lung lesion: Adequacy of transbronchial sampl
 
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Diagnostic yield of fluoroscopy-guided transbronchial biopsy in peripheral lung lesion: Adequacy of transbronchial sample for genotyping tumor

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image: gehealthcare.com


Stefano Baglioni1, Gaetano Cicchitto1, Fabrizio Mezzasalma1, Elvio Scoscia1 and Maurizio Dottorini1
1Pulmonary and Respiratory Intensive Care Unit, S.M della Misericordia Hospital, Perugia, Italy


INTRODUCTION 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.

Aim of the study was to evaluate the diagnostic yield of fluoroscopy guided TBLB and the adequacy of sample for molecular testing in adenocarcinoma subtype.

METHODS 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 instability.

All 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.

RESULTS 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 (> 90%).

Diagnosis N.
Lung cancer 115
Lymphoma 4
Carcinoids 3
Secondary tumors 9
Benign lesions 36
CONCLUSIONS 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
Image : http://www3.gehealthcare.com/~/media/images/product/product-categories/x-ray/flouroscopy/fluoroscopy-main3.jpg


PP-PDPI. 28/07/17.



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