Subpleural versus deep lung biopsies obtained during pleuroscopy for histological examination: an experimental animal study.

BACKGROUND

Lung biopsies obtained during medical pleuroscopy using coagulating forceps could represent a cost-effective alternative to surgical lung biopsies in patients with diffuse parenchymal lung diseases (DPLD). However, it is not clear whether these patients should undergo deeplung biopsies rather than more superficial subpleural lung biopsies.

OBJECTIVES

The aim of this experimental animal study was to compare gross and microscopic features of deep and subpleural pleuroscopic lung biopsy samples.

METHODS

Six male sheep (median weight 40 kg) underwent lung biopsies via pleuroscopy under general anesthesia. The following parameters were studied: weight, size, quality of the parenchyma and visceral pleura, parenchymal vessels and bronchial tissue.

RESULTS

The mean number of biopsies taken per animal was 4.5 ± 1.22 and 4.83 ± 1.33 (p = 0.36) for deep and subpleural biopsies, respectively. The mean size of deep and subpleural biopsies was 1.758 ± 0.478 and 1.283 ± 0.851 cm(2), respectively (p = 0.0006). The mean weight of deep biopsies and subpleural biopsies was 0.156 ± 0.092 and 0.145 ± 0.047 mg, respectively (p = 0.83). No statistically significant difference was found between subpleural and deep biopsies regarding the mean quality scores of parenchyma-pleura (p = 0.36), vessels (p = 0.36), or bronchial tissue (p = 0.20).

CONCLUSION

Both subpleural biopsies obtained during pleuroscopy and deep lung biopsy specimens obtained by electrocautery in animal subjects provided satisfactory material for histologic examination. Therefore, in DPLD, where the subpleural layers are involved, subpleural biopsies obtained during pleuroscopy might be sufficient for establishing an accurate diagnosis.