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In order to definitely compare the ability of TBLCs to identify accurately a specific histological pattern, both techniques (TBLCs and SLBs) should be performed in the same patients.
In conclusion, our data confirm the role of TBLCs for the multidisciplinary diagnosis of DPLDs when a lung biopsy is required.
Caption: FIGURE 2: Detailed diagnoses obtained after TBLCs (and SLBs when applicable).
TBLCs were performed in the left lower lobe and the pathological analysis identified an NSIP pattern (hematoxylin and eosin staining, magnification x40) (b).
TABLE 2: Complications and histological diagnosis of the TBLCs (N = 30).
Therefore, the indication of SLBs has to be carefully taken by the multidisciplinary team and the development of less invasive technique has emerged: thoracic surgeons, who originally performed an open lung biopsy, developed the VATS surgery, and, for a few years, transbronchial lung cryobiopsy (TBLC) has been described for the diagnosis of DPLDs.
APTT: Activated partial thromboplastin time BMI: Body mass index CVD-ILD: Collagen vascular disease-associated interstitial lung disease D-ILD: Drug-induced interstitial lung disease DLCO: Diffusion capacity for carbon monoxide DPLD: Diffuse parenchymal lung disease FVC: Forced vital capacity HP: Hypersensitivity pneumonitis HRCT: High resolution computed tomography ICU: Intensive care unit INR: Prothrombin time international normalized ratio IPF: Idiopathic pulmonary fibrosis MDD: Multidisciplinary discussion mPAP: Mean pulmonary artery pressure NSIP: Nonspecific interstitial pneumonia SLB: Surgical lung biopsy TBLC: Transbronchial lung cryobiopsy UIP: Usual interstitial pneumonia VATS: Video-assisted thoracoscopic surgery.
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