Search

The aim of the work was to assess the value of biopsy techniques for fibrobronchoscopy under local anesthesia in patients with pulmonary pathology at the prehospital level. It included 706 subjects with lobular, segmental or diffuse lesions in the lungs of specific (tuberculosis), non-specific (pneumonia, exogenous alveolitis), and other origin. All known methods of endobronchial biopsy were employed (bronchoalveolar lavage or liquid lung biopsy, tissue biopsy, transbronchial biopsy, brush biopsy, puncture and aspiration biopsy) with subsequent cytomorphological and bacteriological studies of bioptates. Diagnostic efficiency of direct biopsy was estimated at 97%, transbronchial biopsy at 5-90% depending on nosological form of lung disease, brush and puncture biopsy 20-50 and 6% respectively. Reversible complications occurred in 1.4% and were resolved by therapeutic methods. Cost effectiveness of prehospital instrumental examination of patients with pulmonary pathology is 10 times the intrahospital one.

A study is presented of 52 patients with disseminated pulmonary lesions. Among them: histiocytosis X--17, alveolar microlithiasis--5, pulmonary phospholipoproteinosis--7, idiopathic hemosiderosis--14, primary pulmonary amyloidosis--1, primary diffuse lung tumours--8. All patients were subjected to complex bronchological examination including use of different biopsy transbronchial methods as well as open biopsy of the lung. The diagnostic value of the employed bronchial biopsies is discussed. A diagnostic algorithm of rarely met pulmonary disseminations has been developed. Recommendations on the use of different instrumental methods are formulated.

A case of alveolar microlithiasis diagnosed on the basis of a clinical and x-ray picture was described. The diagnostic value of an endopulmonary cytogram in this patient was discussed. The authors investigated bronchoalveolar washing off obtained from bronchoalveolar lavage for morphological diagnosis of this pathology.