, Volume 191, Issue 6, pp 619–624 | Cite as

Transbronchial Cryobiopsy in Immunocompromised Patients with Pulmonary Infiltrates: A Pilot Study

  • Oren FruchterEmail author
  • Ludmila Fridel
  • Dror Rosengarten
  • Nader Abed-el Rahman
  • Mordechai R. Kramer



In immunocompromised patients with pulmonary infiltrates, transbronchial lung biopsies (TBB) obtained by forceps has been shown to increase the diagnostic yield over simple bronchoalveolar lavage. Cryo-TBB is a novel modality for obtaining lung biopsies. We aimed to evaluate for the first time the efficacy and safety of cryo-TBB in immunocompromised patients.


Fifteen immunocompromised patients with pulmonary infiltrates underwent cryo-TBB. During the procedure two to three biopsy samples were taken. Procedure characteristics, complications, and the diagnostic yield were retrospectively evaluated.


Most patients (n = 11) were immunocompromised due to hematological malignancies. The remaining four patients were receiving chronic immunosuppressive treatment due to previous solid-organ transplantation (n = 2) or collagen-vascular disease (n = 2). No major complications occurred in the cryo-TBB group. The mean surface area of the specimen taken by cryo-TBB was 9 mm2. The increase in surface area and quality of biopsy samples translated to a high percentage of alveolated tissue (70 %) that enabled a clear histological detection of the following diagnoses: noncaseating granulomatous inflammation (n = 2), acute interstitial pneumonitis consistent with drug reaction (n = 5), nonspecific interstitial pneumonia fibrotic variant (n = 1), diffuse alveolar damage (n = 3), organizing pneumonia (n = 3), and pulmonary cryptococcal pneumonia (n = 1). Diagnostic information obtained by cryo-TBB led to change in the management of 12 patients (80 %).


Cryo-TBB in immunocompromised patients with pulmonary infiltrates provides clinically important diagnostic data with a low complication rate. These advantages should be further compared with traditional forceps TBB in a prospective randomized trial.


Bronchoscopy Pathology Infection 



Transbronchial biopsy


Bronchoalveolar lavage






Bone marrow transplantation




Conflict of interest

The authors have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Oren Fruchter
    • 1
    • 2
    Email author
  • Ludmila Fridel
    • 2
    • 3
  • Dror Rosengarten
    • 1
    • 2
  • Nader Abed-el Rahman
    • 1
    • 2
  • Mordechai R. Kramer
    • 1
    • 2
  1. 1.The Pulmonary DivisionRabin Medical Center, Beilinson HospitalPetah TikvaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.The Pathology DivisionRabin Medical CenterPetah TikvaIsrael

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