to make the diagnosis' including needle aspiration' BAL' transbronchial biopsy'
open-lung biopsy' and mediastinoscopy.
In a group of patients with ARDS who underwent diagnostic
open-lung biopsy, nine of 19 patients with a previous diagnosis of malignancy were found to have diffuse tumor infiltration of their lungs (four cases of leukemia and one case each of lymphoma, angiosarcoma, histiocytosis, adenocarcinoma and choriocarcinoma) (10).
A final cancer determination was made after several months of follow-up and, in some cases,
open-lung biopsy. The bronchoscopies had detected roughly half of the cancers in the group, and the genetic signatures of the windpipe cells had revealed 80 percent.
However--thanks to some evidence in the literature suggesting the value of
open-lung biopsy in acute respiratory distress syndrome, as well as the patients' severe condition--he performed broncho alveolar lavage.
Bronchoscopy and
open-lung biopsy revealed interstitial pneumonitis with lymphocytes and plasma cells.
AFOP patients in our reports were all pathologically diagnosed using TNB and TBLB and no patients received
open-lung biopsy; however, four of these patients underwent TBLB and TNB successively, and results were exhibited stably as AFOP despite different sampling biopsy methods [Figure 1].
(9) In addition, in a group of patients with ARDS who underwent diagnostic
open-lung biopsy, (10) nine of 19 patient with a previous diagnosis of malignancy were found to have diffuse tumor infiltration of their lungs (four cases of leukemia and one case each of lymphoma, Angiosarcoma, Histiocytosis, Adenocarcinoma and Choriocarcinoma).
[section] When sufficient clinical criteria for a definitive diagnosis of HP are lacking, lung biopsy may be indicated (9, 10); in addition, because transbronchial biopsy may sample unrepresentative areas of the lung, thoracoscopic or
open-lung biopsy may be required.
Thus, transbronchial biopsy is often nondiagnostic in our experience, in agreement with the experience of others reported in the literature.[25] If there is a clinical suspicion of PTLD and transbronchial biopsy is negative,
open-lung biopsy is indicated.
Efforts to diagnose the pneumonia, which included bronchoalveolar lavage and transbronchial biopsy, were unsuccessful until an
open-lung biopsy was performed.
The
open-lung biopsy of the right upper lobe of the lung in 1997 revealed a diffuse lymphoid infiltrate that resembled the previous lung biopsy, but had greater architectural distortion, focal necrosis, and greater mitotic activity and cytologic atypia.