Abstract
The indications and limitations of transbronchial lung biopsy (TBLB) were examined on the basis of an analysis of 100 cases experienced in our department and also of questionnaires obtained from 94 institutes in Japan On the analysis of our 100 cases, a definitive histological diagnosis was obtained with a high rate of accuracy when the lesion was located in parenchyma including alveoli, however, diagnosis was very difficult when the disease mainly involved bronchioles or old lesions. Additionally, the histological appearance was significantly influenced by treatment. It was more frequently possible to make a histological diagnosis was obtained when the number of biopsy specimens was increased. In our experience, at least four biopsy specimens are required for a definitive diagnosis. We sent questionnaires to 148 institutes in Japan, and received 94 replies. It has been suggested that TBLB is useful technique to diagnose diffuse pulmonary diseases, however, the analysis of questionnaires revealed that many institutes have applied this technique for regional and/or solitary lesions. The premedication used varied among the institutes. Fifty-three institutes perform TBLB with tracheal intubation and 41 institutes without intubation. More than 90% of the 94 institutes obtained 3-5 biopsy specimens but the biopsy sites varied. Most frequent complications were pneumothorax and hemorrhage which were experienced by 76.3% and 68.8% of all institutes, respectively. Six cases died following TBLB, four of which due to the massive hemorrage. To prevent these complications, 34 institutes have applied some preventive measure.
