Bronchoscopic Lung Biopsy With Fluoroscopy to Study 164 Localized Pulmonary Lesions

TO assess the usefulness of bronchoscopic lung biopsy (BLB) in the diagnosis of localized pulmonary lesions. A prospective, descriptive study of consecutive patients with a suspected neoplastic nodule, mass, or infiltrate with nonspecific bronchoscopic findings after performing BLB with fluoroscopy. The lesions, clinical and patient characteristics, and outcomes were evaluated. One hundred sixty-four patients with a mean (SD) age of 65 (12) years and a total of 156 masses or nodules and 8 infiltrates (144 neoplasms and 20 nonneoplastic lesions) participated in the study. On average, the lesion was 4.3 (2) cm in diameter and 6 (2) BLBs were performed on each patient, with a rate of serious complications of less than 1%. BLB was diagnostic in 113 cases (69% of the neoplasms and 70% of the nonneoplastic). In cases diagnosed by BLB, the lesions were larger (4.6 [2] cm), more samples were obtained (6 [2] biopsies), nondiagnostic endoscopic alterations were found (30%), and the bronchus sign was present (22%). Moreover, bronchoscopy was better tolerated by those patients. BLB with fluoroscopy increased the diagnostic yield of bronchoscopy for localized lesions with nonspecific findings, regardless of etiology. Larger neoplasms, the bronchus sign, good tolerance, and more tissue samples increased the number of diagnoses, with few complications. Analizar la utilidad de las biopsias pulmonares broncoscópicas (BPB) en el diagnóstico de las lesiones pulmonares localizadas. Estudio descriptivo y prospectivo de pacientes consecutivos con un nódulo, masa o infiltrado sospechosos de neoplasia y con una broncoscopia inespecífica, después de realizar BPB con fluoroscopia. Se valoraron las lesiones, las características antropométricas, clínicas y los resultados. Se incluyó en el estudio a 164 pacientes, con una edad media ± desviación estándar de 65 ± 12 años, con un total de 156 masas o nódulos y 8 infiltrados (144 neoplasias y 20 no neoplásicos). El diámetro de la lesión fue de 4,3 ± 2 cm y se realizaron 6 ± 2 BPB por paciente, con menos del 1% de complicaciones graves. En 113 casos, la BPB fue diagnóstica (un 69% de neoplasias y el 70% no neoplasias). En los casos con BPB diagnóstica, las lesiones tenían mayor tamaño (4,6 ± 2 cm), aumentó el número de BPB (6 ± 2 biopsias), tenían al-teraciones endoscópicas no diagnósticas (30%), el signo del bronquio (22%) y mejor tolerancia a la exploración. Las BPB con fluoroscopia aumentaron la rentabilidad de la broncoscopia en las l