The term “conventional biopsy techniques” implies all those traditional sampling techniques that can be used without adopting the latest technology. Even if the diagnostic possibilities and sensitivity of bronchoscopy have greatly increased by the more recent advent of new technological tools (echobronchoscopy, new guidance systems, cryobiopsy), the use of conventional biopsy techniques remains relevantly unchanged and allows the pulmonologist to successfully approach a high percentage of endobronchial, pulmonary and mediastinal lesions for diagnostic purposes. In this chapter, conventional biopsy techniques will be divided on the basis of the location of the lesion, analyzing methods used for sampling central endobronchial lesions (i.e., lesions located within the visible range of flexible bronchoscope), peripheral pulmonary lesions or lung parenchyma and the pathological processes of the hilar–mediastinal area. Indications, technique, possibilities and limits of each sampling method (forceps biopsy, brushing, bronchial washing, transbronchial needle aspiration) and of its association are reported. Whenever a biopsy technique is employed, its use must always be guided by a global clinical assessment of the patient, evaluating the risk/advantage ratio and the benefits that can be obtained by the procedure case by case. Only by integrating clinical, imaging and bronchoscopic techniques, it will be possible to optimize bronchoscopy, thereby obtaining the best diagnostic accuracy, minimizing the costs involved and having the lowest incidence of risks.

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Conventional Biopsy and Sampling Techniques

  • Stefano Gasparini,
  • Nadia Corcione,
  • Lina Zuccatosta

摘要

The term “conventional biopsy techniques” implies all those traditional sampling techniques that can be used without adopting the latest technology. Even if the diagnostic possibilities and sensitivity of bronchoscopy have greatly increased by the more recent advent of new technological tools (echobronchoscopy, new guidance systems, cryobiopsy), the use of conventional biopsy techniques remains relevantly unchanged and allows the pulmonologist to successfully approach a high percentage of endobronchial, pulmonary and mediastinal lesions for diagnostic purposes. In this chapter, conventional biopsy techniques will be divided on the basis of the location of the lesion, analyzing methods used for sampling central endobronchial lesions (i.e., lesions located within the visible range of flexible bronchoscope), peripheral pulmonary lesions or lung parenchyma and the pathological processes of the hilar–mediastinal area. Indications, technique, possibilities and limits of each sampling method (forceps biopsy, brushing, bronchial washing, transbronchial needle aspiration) and of its association are reported. Whenever a biopsy technique is employed, its use must always be guided by a global clinical assessment of the patient, evaluating the risk/advantage ratio and the benefits that can be obtained by the procedure case by case. Only by integrating clinical, imaging and bronchoscopic techniques, it will be possible to optimize bronchoscopy, thereby obtaining the best diagnostic accuracy, minimizing the costs involved and having the lowest incidence of risks.