폐질환의 진단에 있어 경기관지폐생검의 활용에 과한 연구 = A Study for Transbronchial Lung Biopsy on the Diagnosis of Pulmonary Diseases

다국어 초록 (Multilingual Abstract)

Transbronchial lung biopsy through the rigid bronchoscope was developed by Anderson in 1965. Recently, Transbronchial lung biopsy has become more popular with introduction of fiberoptic bronchoscope. To investigate the usefulness of transbronchial lung biopsy in clinical decision making, auther reviewed 212 consecutive TBLB procedure of which 21 were lost to follow up with respect to clinical presentation and roentgenographic patterns of diseases. A histologic diagnosis was made in 134 of 191 cases(70.2%), in which 105 of 153(68.6%) with localized lesions and 29. of 38 (76.3%) with diffuse lung lesions. In 94 patients with lung malignancy, the diagnostic yield was 63,8%. The most important characteristic associated with positive cyto-or histopathologic diagnosis was the size of lesion: the yield was 36% when the diameter was less than 3,0cm, in comparison to 75% among lesions of 3 cm or more in diameter(P<0. 005). There were no significant differences in diagnostic yield for the segmental location and greatest distance from carina on either the posteroanterior or lateral radiograph. Furthermore the nature of the lesion inaccordance with bronchus-tumor relationship might be a contributary factor for yield rate. In case of a nonspecific TBLB, it was valuable only in 20.5% of the cases, and other form of invasive procedures or close clinical follow up was mandatory for verification. In conclusion, fluoroscopy guided TBLB is a. reasonable diagnostic procedure with fairly good yield rate and safety. But fine needle aspiration cytology might be a complementary procedure to overcome the limitation of TBLB and get higher diagnostic yield for peripheral lung lesions.