Eight Years' Experience With Pulmonary Biopsy

• Pulmonary biopsy is carried out under general anesthesia through an incision in the anterior third or fourth intercostal space. While the anesthetist applies positive pressure, the lung is grasped with a noncrushing clamp and advanced into the incision for the removal of the needed tissue specimen. It is suitable for the diagnosis of diffuse pulmonary conditions, such as those produced by systemic disease, in which a small specimen can be expected to reflect the state of the lung as a whole. It has been done in 118 patients. Complications followed in 14 cases, but have been less frequent in the more recent cases. The data have been valuable in either confirming or disproving the initial diagnosis and so determining the course of treatment. The initial diagnosis of pneumoconiosis, for example, was confirmed in only 10 of 23 patients; the true diagnosis proved to be carcinoma in 2 patients, sarcoidosis in 4, and nonspecific infection or fibrosis in 7. Similar data on the accuracy of other initial diagnoses showed that in many cases the data supplied by a pulmonary biopsy enables the patient to avoid prolonged and costly hospitalization.