Single versus multiple lung biopsies for suspected interstitial lung disease

Asian Cardiovasc Thorac Ann. 2016 Oct;24(8):788-791. doi: 10.1177/0218492316665551. Epub 2016 Aug 17.


Background: There is a belief that in patients with suspected interstitial lung disease, multiple biopsies from different lobes are more likely to result in a diagnosis. We compared the results of single biopsies with those of multiple biopsies in terms of positive yield of histological diagnoses and the patients' postoperative outcomes.

Methods: Data of 115 patients who underwent video-assisted thoracoscopic lung biopsy, between 2009 and 2015, for suspected interstitial lung disease were analyzed retrospectively and grouped according to single or multiple lung biopsies. High-resolution computed tomography of the chest was reviewed prior to the procedure, and the most appropriate areas for sampling were chosen. Data analysis was carried out with the Mann-Whitney U test, using MedCalc version 16.1 statistical software.

Results: Of the 115 patients, 67 had a single biopsy and 48 had more than one biopsy. A histological diagnosis was arrived at in all cases. The duration of chest drainage (p = 0.033) and postoperative hospital stay (p = 0.012) were longer in the multiple-biopsies group.

Conclusion: A single lung biopsy is sufficient to arrive at a diagnosis of interstitial lung disease when the sampling site is guided by high-resolution computed tomography and a multidisciplinary approach. Multiple biopsies are less cost-effective, offer no added advantage in terms of diagnostic yield, and are associated with more morbidities and a longer hospital stay.

Keywords: Biopsy; Diagnosis; Lung diseases; Pulmonary fibrosis; Thoracoscopy; differential; interstitial.

Publication types

  • Comparative Study

MeSH terms

  • Biopsy / adverse effects
  • Biopsy / methods*
  • Chest Tubes
  • Drainage / instrumentation
  • Humans
  • Length of Stay
  • Lung Diseases, Interstitial / pathology*
  • Lung Diseases, Interstitial / therapy
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors
  • Thoracic Surgery, Video-Assisted* / adverse effects
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome