Histology (haematoxylin and eosin stained) obtained by means of
open lung biopsy. (A) Subpleural architectural distortion with fibrosis (star) and abnormal airspaces and bronchiolar metaplasia (arrow) (100x magnification).
Open lung biopsy was performed by formal thoracotomy avoiding honeycombing areas.
Efficacy of thoracoscopic lung biopsy in interstitial lung disease: comparison with
open lung biopsy. J Coll Physicians Surg Pak 2003; 13(10): 600-3.
Consequent
open lung biopsy revealed chronic and subacute small airways injury morphologically consistent with constrictive bronchiolitis.
At the end, an
open lung biopsy with thoracotomy for interstitial lung disease and thymectomy were performed, and the pathologic diagnosis was as micronoduler type thymoma, surrounded by monoclonal B cell proliferation approved by molecular clonality studies and also amyloid accumulation in the lung, which was shown to be AL type of amyloid by mass spectrometry (Figure 2).
Miller published the largest case series to date in which
open lung biopsy was used to diagnose 38 cases of constrictive bronchiolitis and 11 other lung ailments in 49 Fort Campbell soldiers with unexplained exertional dyspnea and normal pulmonary-function and cardiopulmonary-exercise testing (N.
As the lesion resolved with steroid therapy no other invasive procedure such as bronchoscopy or
open lung biopsy was applied to the patient.
Dr christina Anderlind said: "The current tests are highly invasive, such as
open lung biopsy. But the nose could be used to diagnose it in the early stages, when there is a greater chance of long-term survival.
(4) However, because of the high rates of co-infection, a definitive diagnosis of CMV requires identification of CMV intranuclear or cytoplasmic inclusion bodies in transbronchial biopsy specimens (used in our patients) or
open lung biopsy specimens.
Subsequent
open lung biopsy sample showed necrotizing granulomatous inflammation with possible vascular involvement suggestive of Wegener granulomatosis.
Open lung biopsy - small pieces of lung tissue are removed through a cut in the chest wall between the ribs.