The Endobronchial Ultrasound-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions

Background: Peripheral pulmonary lesions are technically challenging with conventional bronchoscopy in obtaining tissue diagnosis. The recently developed small-caliber ultrasonographic probe can be introduced via the working channel of a flexible bronchoscope to localize peripheral pulmonary lesions (PPLs) prior to transbronchial lung biopsy (TBLB). The endobronchial ultrasound-guided transbronchial lung biopsy (EBUSTBLB) is a new diagnostic method for the diagnosis of pulmonary lesions in our center. Objective: To evaluate the diagnostic yield of EBUS-TBLB in pulmonary lesions. Study design: A prospective cross-sectional study Material and Method: We enrolled 152 patients with pulmonary lesions that were beyond the segmental bronchus and had no evidence of endobronchial lesion, who underwent bronchoscopy in our center. With EBUS assisted, transbronchial lung biopsy was performed after localizing and measuring distance from the tip of bronchoscope to the lesion. The diagnostic yield was calculated. Results: The pulmonary lesions were visible on EBUS image in 98.7% of cases. The overall diagnostic yield of EBUS-TBLB was 66.4%. The diagnostic yield in the infiltrative and mass lesions were 86.4% and 63.1%, respectively. The lesions which EBUS probe located within it were diagnosed by EBUS-TBLB about 74.8%. The benign and malignant lesions were diagnosed by EBUS-TBLB about 81.1% and 58.6%, respectively. The average EBUS time was 3.55 + 2.29 minutes. No complication of EBUS and transbronchial lung biopsy were observed in this study. Conclusion: EBUS-TBLB is a safe procedure for diagnosing pulmonary lesions. Our results indicate that the EBUS-TBLB improves the diagnostic yield compared to conventional brochoscopy. Keywords: bronchoscopy, endobronchial ultrasound, miniature probe, transbronchial lung biopsy, peripheral pulmonary lesions