Abstract Rationale Transbronchial lung cryobiopsy (TBLC) is an emerging technique for obtaining lung tissue for histopathologic evaluation, offering a minimally invasive alternative to surgical lung biopsy. Data on its use in children remain limited. We aim to characterize the early clinical experience, safety, and diagnostic yield of TBLC in a pediatric population. Methods This single-center, retrospective cohort study included patients who underwent TBLC for evaluation of pulmonary parenchymal lesions and diffuse lung disease. Demographic, procedural, and outcome data were collected. Results Nineteen procedures were performed in 18 patients aged 2-20 years between May 2024 and September 2025. All procedures were performed with a 1.1 mm cryoprobe with a 3-5 second freeze time, yielding 1-5 specimens per procedure. Tissue samples measured from 2-12 mm in diameter. Supplementary navigation tools were frequently used, including radial endobronchial ultrasound (84%), fluoroscopy (42%), virtual bronchoscopic navigation (32%), and cone beam computed tomography (16%). The most common indications for biopsy were pulmonary nodules (52%) and ground glass opacities (32%), with some cases having overlapping findings. Tissue adequacy was 100%. A pathologic diagnosis was made based on tissue alone in 37% of cases and following multidisciplinary discussion in 95%. Multidisciplinary discussion incorporated pathology findings, culture results, and clinical context. One patient required repeat TBLC due to lack of diagnostic certainty. None required subsequent surgical lung biopsy. Diagnoses were benign non-infectious in 63%, benign infectious in 32%, and malignant in 11%. Mild bleeding occurred in 79% of procedures (grade 1-2). Moderate bleeding occurred in 11% (grade 3). No severe bleeding or pneumothoraces were observed. Conclusions TBLC is a feasible and effective method for obtaining diagnostic lung tissue in children, with a high diagnostic yield and an acceptable safety profile. While mild-to-moderate bleeding is common, serious complications are rare. These findings support TBLC as a valuable tool in the diagnostic evaluation of pediatric lung disease and warrant further prospective studies to optimize safety and standardize procedural techniques. This abstract is funded by: None
Haskett et al. (Fri,) studied this question.