Trephine Air Drill, Bronchial Brush, and Fiberoptic Transbronchial Lung Biopsies in Immunosuppressed Patients1–3

Seventy-nine nonthoracotomy lung and bronchial biopsy procedures were performed in 52 immunosuppressed patients: 22 renal transplants, 24 lymphoreticular malignancies, and 6 other disorders. The total diagnostic yield was 74 per cent (23 of 31) of the forceps transbronchial biopsy procedures, 82 per cent (14 of 17) of the percutaneous trephine lung biopsies, and 28 per cent (9 of 31) of the bronchial brush biopsies. An etiologic diagnosis, including a variety of viral, fungal, and parasitic diseases, was obtained in 42 per cent (13 of 31) of the transbronchial biopsy procedures and 65 per cent (11 of 17) of the percutaneous trephine lung biopsies. The etiologic diagnostic yield was increased to 48 per cent when bronchial brushing was combined with forceps transbronchial biopsy. Hemorrhage complicated 26 per cent of the transbronchial biopsy procedures and 17 per cent of the percutaneous trephine biopsies, whereas pneumothorax occurred in 19 per cent and 60 per cent, respectively. Hemorrhagic complications...