Multidisciplinary discussion for diagnosis of lung diseases: A retrospective analysis of 217 cases undergoing non-tumor lung biopsy

Abstract

Objective To study on the diagnostic value of non-tumor lung biopsy by the multidisciplinary discussion including clinician, radiologist and pathologist. Methods Clinical data, imaging data and data of hematoxylin-eosin, immunohistochemical and special staining of pathological lung tissues in 217 cases undergoing non-tumor lung biopsy in Beijing Hospital during July 2015 to July 2018 were retrospectively analyzed.The diagnosis results were summarized and analyzed. Results The age range in 217 cases was 45-89 years, and the median age was 67 years, with 92 females and 125 males.The descriptive diagnoses were found in forty-two cases(19.4%, 42/217). And 175 cases could be confirmatively diagnosed by the multidisciplinary discussion of clinician, radiologist and pathologist.And the diagnostic rate of lung puncture biopsy was 80.6%(175/217 cases). Inflammatory lesions were divided into infection and non-infection.A total of 68 infection cases(31.3%, 68/217)included tuberculosis(43/68, 63.2%), bacterial pneumonia(14/68, 20.6%)and fungal infection(11/68, 16.2%). A total of 107 cases(49.3%, 107/217)of non-infective cases included the following: organized pneumonia(53/107, 49.5%), interstitial pneumonia with autoimmune features(iPAF)(16/107, 15.0%), nonspecific interstitial pneumonia(NSIP)(13/107, 12.1%), hypersensitivity pneumonitis(8/107, 7.5%), granulomatosis with polyangiitis(GPA)(4/107, 3.7%), eosinophilic pneumonia(2/107, 1.9%), sarcoidosis(2/107, 1.9%), acute fibrinous and organizing pneumonia(AFOP)(2/107, 1.9%)and coal pneumoconiosis(2/107, 1.9%, for each), and IgG4 related diseases(1/107, 0.9%), pleuraparenchymal fibroelastomatosis(PPFE)(1/107, 0.9%), asbestos lung(1/107, 0.9%), lipid pneumonia(1/107, 0.9%)and inhaled pneumonia(1/107, 0.9%). Conclusions The diagnoses of the puzzled non-tumor lung diseases were more accurate by pathological examination of lung tissue by using special stain, immunohistochemical stain and other pathological means, and by close multidisciplinary consultation of clinician, radiologist and pathologist, so as to facilitate the diagnosis and treatment of diseases. Key words: Biopsy, needle; Lung disease, interstitial; Immunohistochemistry