Evaluation of Bronchoscopic Cryo_biopsy for Endobronchial and Parenchymal Lung Diseases .

Abstract

Background Bronchoscopic lung biopsies are crucial for diagnosing both endobronchial and parenchymal lung lesions. Forceps biopsy, though standard, is limited by small specimen size, crush artifacts, and reduced diagnostic yield, particularly in parenchymal disease. Cryobiopsy has emerged as a promising alternative that may overcome these limitations.

Objectives To compare the diagnostic yield, histopathological specimen quality, and complication rates of bronchoscopic cryobiopsy and forceps biopsy in lung lesions.

Patients and Methods This prospective, single-center comparative study was conducted in the bronchoscopy unit at Ain Shams University Hospitals. Patients with endobronchial or parenchymal lung lesions underwent both flexible cryobiopsy and forceps biopsy in an alternating sequence. Specimen characteristics, diagnostic yield and procedure-related complications were assessed.

Results Among 38 patients with endobronchial or bronchial lesions, cryobiopsy yielded significantly larger tissue specimens compared to forceps biopsy (p = 0.001) and a higher diagnostic yield (92.1% vs. 71.1%, p = 0.021). Similarly, in 14 patients with parenchymal lung lesions, cryobiopsy outperformed forceps biopsy, providing larger tissue specimens (p = 0.002) and achieving a higher diagnostic yield of (92.9% vs. 42.9%, p = 0.039). Complications were observed with both techniques, however, cryobiopsy was associated with a higher incidence of moderate bleeding. Importantly, all bleeding episodes were effectively managed bronchosocpically. Pneumothorax occurred in two cases (14.3%), and no procedure-related mortality was reported.

Conclusion Cryobiopsy provides larger, higher-quality specimens and achieves superior diagnostic yield compared with forceps biopsy in both endobronchial and parenchymal lesions. Although it is associated with a higher incidence of moderate bleeding, it remains a safe and effective diagnostic technique.