Transbronchial biopsy interpretation in the patient with diffuse parenchymal lung disease

Kevin O. Leslie, James F. Gruden, James M. Parish, Mary Beth Scholand

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Context. - The most common lung tissue samples seen by pathologists worldwide are obtained with the flexible bronchoscope. Specimens taken for examination of diffuse or multifocal parenchymal lung abnormalities pose special challenges for the general surgical pathologist, and these challenges are often compounded by high clinical expectations for accurate and specific diagnosis. Objective. - To present and discuss the most common histopathologic patterns and diagnostic entities seen in transbronchial biopsy specimens in the setting of diffuse or multifocal lung disease. Specifically, acute lung injury, eosinophilic pneumonia, diffuse alveolar hemorrhage, chronic cellular infiltrates, organizing pneumonia, alveolar proteinosis, sarcoidosis, Wegener granulomatosis, intravenous drug abuse-related microangiopathy, Langerhans cell histiocytosis, and lymphangioleiomyomatosis are presented. Clinical and radiologic context is provided for the more specific diagnostic entities. Data Sources. - The published literature and experience from a consultation practice. Conclusions. - The transbronchial biopsy specimen can provide valuable information for clinical management in the setting of diffuse or multifocal lung disease. Computed tomographic scans are useful for selecting appropriate patients to undergo biopsy and in limiting the differential diagnosis. Knowledge of the clinical context, radiologic distribution of abnormalities, and histopathologic patterns is essential. With this information, the surgical pathologist can substantially influence the diagnostic workup and help guide the clinician to an accurate clinical/radiologic/pathologic diagnosis.

Original languageEnglish (US)
Pages (from-to)407-423
Number of pages17
JournalArchives of Pathology and Laboratory Medicine
Volume131
Issue number3
StatePublished - Mar 2007

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Interstitial Lung Diseases
Biopsy
Lung Diseases
Intravenous Substance Abuse
Lymphangioleiomyomatosis
Pulmonary Eosinophilia
Bronchoscopes
Lung
Information Management
Langerhans Cell Histiocytosis
Granulomatosis with Polyangiitis
Acute Lung Injury
Information Storage and Retrieval
Sarcoidosis
Pneumonia
Differential Diagnosis
Referral and Consultation
Hemorrhage
Pathologists

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Leslie, K. O., Gruden, J. F., Parish, J. M., & Scholand, M. B. (2007). Transbronchial biopsy interpretation in the patient with diffuse parenchymal lung disease. Archives of Pathology and Laboratory Medicine, 131(3), 407-423.

Transbronchial biopsy interpretation in the patient with diffuse parenchymal lung disease. / Leslie, Kevin O.; Gruden, James F.; Parish, James M.; Scholand, Mary Beth.

In: Archives of Pathology and Laboratory Medicine, Vol. 131, No. 3, 03.2007, p. 407-423.

Research output: Contribution to journalArticle

Leslie, KO, Gruden, JF, Parish, JM & Scholand, MB 2007, 'Transbronchial biopsy interpretation in the patient with diffuse parenchymal lung disease', Archives of Pathology and Laboratory Medicine, vol. 131, no. 3, pp. 407-423.
Leslie, Kevin O. ; Gruden, James F. ; Parish, James M. ; Scholand, Mary Beth. / Transbronchial biopsy interpretation in the patient with diffuse parenchymal lung disease. In: Archives of Pathology and Laboratory Medicine. 2007 ; Vol. 131, No. 3. pp. 407-423.
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