The diagnostic yield of open lung biopsy in relation to clinical and radiological features in patients with suspected interstitial lung disease

الملخص EN

Background : the diagnosis of interstitial lung disease (ILD) is frequently delayed, because clinical clues are neglected and respiratory symptoms are ascribed to more common pulmonary diagnosis such as asthma and chronic obstructive pulmonary disease in the primary care setting.

Objective : to evaluate the diagnostic yield of open lung biopsy in patients with suspected ILD in relation to clinical and radiological features.

Patients and methods : thirty-five patients were admitted with suspected interstitial lung disease (ILD), and scheduled for open lung biopsy (OLB) in Ghazi AL-Hariri hospital for surgical specialty, were included in this study.

Data collected from the patient's files (who were subjected to open lung biopsies which had been histopathologically studied in the period from 1st of January 2013 to 31st of May 2015) and were studied retrospectively.

Results : there were 11 (31.4 %) males and 24 ( 68.6 %) females, the mean age was 46 ± 14 years , dyspnea was the common presenting symptoms in patients 24 (68.6 %) , dry cough was the presenting symptoms in10 (28.6 %)patients , bilateral diffuse crepitations were heard in 20 (57.2 %) patients, bilateral fine basal crepitation were heard in 11 (31.4 %) , clubbing with bilateral fine basal crepitations heard in 4 (11.4 %) ,chest-x- rays findings were: lower zone infiltration in 11 (31.4 %), reticulonodular infiltration in 10 (28.6), nodular infiltration in8 (22.9 %) and opacities in6 (17.1 %).

CT findings were: basal infiltration in11 (31.4 %), reticulonodular infiltration in 10 (28.6 %), nodular infiltration in 8 (22.9 %) and ground glass appearance s in 6 (17.1 %).

Histopathological examination (obtained from Open lung biopsy) results were: had usual interstitial pneumonia (idiopathic pulmonary fibrosis) 21(60 %), 7 (20 %) metastasis, 5 (14.3 %) pulmonary TB and 2(5.7 %) broncho-alveolar cell carcinoma.

Conclusion : open lung biopsy can give a high diagnostic yield and confirm or alters the diagnosis in a significant number of patients with suspected interstitial lung diseases.

The usual interstitial pneumonia pattern is the commonest histopathologic pattern seen in ILD patients.