Transbronchial biopsy without fluoroscopy in diffuse lung diseases

Transbronchial biopsy [TBB] is a useful procedure to obtain an alveolar specimen in the evaluation of diffuse lung infiltrates, the use of fluoroscopy during the procedure has been controversial. In the present study, TBB without fluoroscopy was performed in 20 patients with diffuse bilateral lung infiltrates of unknown etiology as an outpatient procedure. All patients were observed for two hours after the procedure and discharged if stable. The overall diagnostic yield was found to be 75%, the highest yield was achieved in sarcoidosis, other interstitial diseases [100%], and metastatic neoplasm [75%]. Complication rate was low [10%]. One patient developed mild pneumothorax which did not necessitate tube insertion, and another one suffered from fever which responded to antipyretics. This report suggested that TBB without fluoroscopy in the lower lobes in diffuse lung diseases is a safe diagnostic procedure with reasonable yield and could be done as an outpatient procedure