What question did this study set out to answer?

The aim is to evaluate the best tissue diagnosis method for interstitial lung diseases with minimal complications.

March 13, 2026Open Access

Diagnostic yield and safety of trans-bronchial lung biopsy with forceps, cryo-biopsy or thoracoscopic lung biopsy in interstitial lung diseases

Key Points

The aim is to evaluate the best tissue diagnosis method for interstitial lung diseases with minimal complications.
Sixty patients were randomly divided into three groups: forceps biopsy, cryobiopsy, and thoracoscopic biopsy.
Each group underwent the specified biopsy technique for tissue diagnosis of interstitial lung diseases.
Diagnostic outcomes and safety measures were analyzed, including complications like pneumothorax and bleeding.
The diagnostic yield was 40% for forceps biopsy, 95% for cryobiopsy, and 100% for thoracoscopic biopsy.
Bleeding occurrence was 55% in the cryobiopsy group compared to 15% for forceps and 5% for thoracoscopic biopsies.
Pneumothorax occurred in 5% of patients who underwent cryobiopsy, with no significant differences in safety across groups.

Abstract

Interstitial lung diseases (ILDs) are characterized by alveolar epithelial damage and lung parenchymal distortion, associated with ultimate extensive parenchymal fibrosis. So, we aimed to assess the appropriate method for tissue diagnosis of ILD with the least complications, either with conventional tranbronchial bronchoscopic forceps biopsy(TBLB), cryo-biopsy(TBCB), or thoracoscopic lung biopsy. Sixty patients, with clinical, laboratory and radiological criteria of ILD, were randomly categorized into 3groups, group (1) included patients underwent bronchoscopic transbronchial forceps biopsy, group (2) included patients underwent Bronchoscopic lung cryobiopsy and group (3) included patients underwent thoracoscopic lung biopsy. A specific pathological diagnosis was achieved in only 8/20 patients (40%) in bronchoscopic forceps biopsy group, compared to 19/20 patient (95%) in bronchoscopic lung cryobiopsy group and 20/20 patients (100%) in thoracoscopic lung biopsy group, with a significant difference (p < 0.001). Whereas the difference between groups (2) and (3) wasn’t significant (p = 0.311). Regarding safety, pneumothorax documented in 5% in cryobiopsy group with no significant difference among the groups (p = 0.362) and bleeding was higher for the cryobiopsy group (55%) vs. 15% in bronchoscopic forceps biopsy group (p = 0.008) and 5% in thoracoscopic lung biopsy group (p = 0.001). Howerver bleeding was mild self-limited and did not need any interventions. This study demonstrated that both transbronchial cryobiopsy (TBCB) and thoracoscopic biopsy offer a dramatically superior diagnostic yield for Interstitial lung diseases (ILDs) compared to conventional TBLB, While TBCB, minimally invasive alternative that nearly matches the diagnostic gold standard of surgery. ClinicalTrials.gov (NCT07432503).

Bookmark

View Full Paper

Cite This Study

Rizk et al. (Tue,) studied this question.

synapsesocial.com/papers/69b3ab0002a1e69014ccbaeb https://doi.org/https://doi.org/10.1186/s43168-026-00547-x

Bookmark

View Full Paper