Role of lung biopsies in the diagnosis of interstitial lung diseases in a clinical real-life setting

Objective: To assess the importance of different tools for diagnosing interstitial lung diseases with specific emphasis on different types of lung biopsies. Methods: Retrospective analysis of data from 150 patients who had entered a multidisciplinary discussion between 01/2019-07/2020. Results: Most common diagnoses were sarcoidosis (N=41, 27.3%), idiopathic pulmonary fibrosis (N=26, 17.3%) and interstitial lung diseases related to connected tissue diseases (N=23, 15.3%). Lung biopsies were performed as follows (Table 1): cryobiopsy (N=13, 8.7%), transbronchial biopsy (N=17, 11.3%) and video-assisted thoracoscopy (N=10, 6.6%). Out of 40 patients with lung biopsies 65% were finally diagnosed (35% unclassified). Idiopathic pulmonary fibrosis was diagnosed without lung biopsy in 88.5% of all cases. Conclusion: In a real life setting, CT Thorax and bronchoalveolar lavage form the core tools for diagnosing different interstitial lung diseases, while the role of lung biopsies is subordinated. This is particularly true for idiopathic pulmonary fibrosis. Table 1: Number of patient [%] with diagnostic procedures (diagnosis unknown in 1 patient)