Exobronchial Pulmonary Eye: Transthoracic Ultrasound-Guided Transbronchial Lung Biopsy in Different Pulmonary Shadows

Background: Transbronchial lung biopsy (TBLB) is one of the most imperative applications of flexible bronchoscopy that may preclude the need for an open lung biopsy. A real-time ultrasonographic guidance may increase the diagnostic yield of TBLB. Purpose: The aim of this study is to evaluate the diagnostic yield of a real-time transthoracic ultrasound-guided transbronchial lung biopsy (TTUS-TBLB) in different pulmonary shadows. Patients and methods: One hundred and seventeen patients with radiological pulmonary shadows were submitted for fiberoptic bronchscopy and underwent either conventional TBLB (cTBLB) that only supported by prior localization with chest computed tomography (CT) in 84 patients (group 1) or under a real-time TTUS-TBLB in 33 patients (group 2). Results: The overall diagnostic yield of TBLB was 74.4% (87 cases out of 117; 79 cases by the first TBLB and 8 cases by second TBLB). The final diagnosis of the enrolled patients was; fifty two cases proved to be malignant (42 cases diagnosed by TBLB) and sixty five cases proved to be nonmalignant (45 cases diagnosed by TBLB). TTUS-TBLB achieved diagnosis in 81.81% of cases and cTBLB achieved diagnosis in 71.43%. Conclusion: The results of real-time TTUS-TBLB were promising and may improve the overall diagnostic yield of TBLB in either benign or malignant pulmonary shadows.