Exploratory Application Of Transbronchial Cryobiopsy In The Diagnosis Of Pneumoconiosis

Objective : To investigate the efficacy and safety of transbronchial cryobiopsy(TBCB)in the diagnosis of pneumoconiosis.Methods:A total of 14 cases with a history of exposure to dust were included in the study and underwent TBCB from May 2016 to November2018.Lung tissue obtained with TBCB was subjected to pathological examination,and then analyzed together with dust exposure history,clinical manifestations and radiologic findings in order to evaluate the effectiveness of TBCB in the diagnosis of pneumoconiosis.Meanwhile,the incidence and severity of complications were observed and recorded to determine the safety of TBCB in the diagnosis of pneumoconiosis.Results : Thirteen cases of TBCB were performed under rigid bronchoscopy combined with flexible bronchoscopy,and 1 case of TBCB was performed under flexible bronchoscopy with endotracheal intubation.The duration of the procedure of TBCB was 50.71±21.86 minutes on average.The number of tissue samples obtained in each case was6.71±1.27,and the median area of tissues was 8 mm2(range 1 – 25 mm2).Pathological diagnosis revealed 11 occupation-related interstitial lung diseases,1 case of usual interstitial pneumonia,1 case of granuloma indicative of proliferative tuberculosis or sarcoidosis,and 1 case of allergic alveolitis.After multidisciplinary discussion,the final diagnoses were 7cases of pneumoconiosis,1 case of usual interstitial pneumonia,1 case of sarcoidosis,1 case of allergic alveolitis,and the diagnosis of 4 cases was unknown.The diagnostic rate was 71.43%(10/14).Among them,2 cases were classified as severe hemorrhage and 3 cases as moderate hemorrhage according to British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults.After hemostastic treatment,the hemorrhages stopped.A moderate pneumothorax occurred in 1 case with 30% of lung collapse,which was absorbed after thoracic drainage.Conslusion : TBCB is a safe and effective lung biopsy technique which provides information on pathological changes of pneumoconiosis,and is of great value in the diagnosis and differential diagnosis of pneumoconiosis.