Skip to main content

Advertisement

Log in

Pulmonary infiltrates in patients with haematologic malignancies: transbronchial lung biopsy increases the diagnostic yield with respect to neoplastic infiltrates and toxic pneumonitis

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

We retrospectively evaluated 107 fiberoptic bronchoscopies with and without transbronchial lung biopsy (TBLB) in 98 consecutive patients with haematologic malignancies and pulmonary infiltrates. Bronchoalveolar lavage (BAL) was performed in 45 and BAL plus TBLB in 62 procedures. There was no procedure-related severe haemorrhage, pneumothorax or death. Infectious aetiology was identified in 26 of 107 (24%), toxic pneumonitis in 17 of 107 (16%) and neoplastic infiltration in 9 of 107 (8.5%) episodes. Combined BAL and TBLB was significantly superior to BAL alone with respect to the diagnosis of neoplastic infiltrates (p=0.008) and toxic pneumonitis (p<0.001) and should therefore be included in the diagnostic work-up of this patient cohort.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cazzadori A, Di Perri G, Todeschini G, Luzzati R, Boschiero L, Perona G, Concia E (1995) Transbronchial biopsy in the diagnosis of pulmonary infiltrates in immunocompromised patients. Chest 107:101–106

    Google Scholar 

  2. Clark BD, Vezza PR, Copeland C, Wilder AM, Abati A (2002) Diagnostic sensitivity of bronchoalveolar lavage versus lung fine needle aspirate. Mod Pathol 15:1259–1265

    Google Scholar 

  3. Dunagan DP, Baker AM, Hurd DD, Haponik EF (1997) Bronchoscopic evaluation of pulmonary infiltrates following bone marrow transplantation. Chest 111:135–141

    Google Scholar 

  4. Epner DE, White P, Krasnoff M, Khanduja S, Kimball KT, Knaus WA (1996) Outcome of mechanical ventilation for adults with hematologic malignancy. J Invest Med 4:254–260

    Google Scholar 

  5. Ewig S, Glasmacher A, Ulrich B, Wilhelm K, Schäfer H, Nachtsheim KH (1998) Pulmonary infiltrates in neutropenic patients with acute leukemia during chemotherapy. Chest 114:444–451

    Google Scholar 

  6. Hilbert G, Gruson D, Vargas F, Valentino R, Gbikpi-Benissan G, Dupon M, Reiffers J, Cardinaud JP (2001) Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N Engl J Med 344:481–487

    Google Scholar 

  7. Maschmeyer G, Beinert T, Buchheidt D, Einsele H, Heussel CP, Kiehl M, Lorenz J (2003) Diagnosis and antimicrobial therapy of pulmonary infiltrates in febrile neutropenic patients. Ann Hematol 82:118–126

    Google Scholar 

  8. Murray PV, O’Brien MER, Padhani AR, Powles R, Cunningham D, Jeanes A, Ashley S (2001) Use of first line bronchoalveolar lavage in the immunosuppressed oncology patient. Bone Marrow Transplant 27:967–971

    Google Scholar 

  9. Sanguinetti M, Posteraro B, Pagano L, Pagliari G, Fianchi L, Mele L, La Sorda M, Franco A, Fadda G (2003) Comparison of real-time PCR, conventional PCR, and galactomannan antigen detection by enzyme-linked immunosorbent assay using bronchoalveolar lavage fluid samples from hematology patients for diagnosis of invasive pulmonary aspergillosis. J Clin Microbiol 41:3922–3925

    Google Scholar 

  10. Wong PW, Stefanec T, Brown K, White DA (2002) Role of fine-needle aspirates of focal lung lesions in patients with hematologic malignancies. Chest 121:527–532

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H. Sill.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mulabecirovic, A., Gaulhofer, P., Auner, H.W. et al. Pulmonary infiltrates in patients with haematologic malignancies: transbronchial lung biopsy increases the diagnostic yield with respect to neoplastic infiltrates and toxic pneumonitis. Ann Hematol 83, 420–422 (2004). https://doi.org/10.1007/s00277-004-0876-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-004-0876-5

Keywords

Navigation