Diagnostic role of tissue acquisition in patients with minimal fibrotic changes and normal lung functions

Data on diagnostic role of tissue acquisition in patients with a clinical scenario of suspected idiopathic pulmonary fibrosis (IPF), but minimal fibrotic changes at computed tomography (CT),slight/absent respiratory symptoms and normal lung functions, are scanty. We report a case-series, from 2 Italian centers (Forli and Ancona),of 15 patients with early fibrotic changes and no functional impairment, who underwent a lung biopsy (transbronchial cryobiopsy or surgical biopsy) in diagnostic work up of suspected IPF. Clinical data and final diagnosis are shown in Table 1. All histopathologic patterns were classified as definite usual interstitial pneumonia (UIP) and all patients received a final diagnosis of IPF(Fig. 1).3 cases of pneumothorax occurred, but none required drainage. Tissue acquisition played a key role in achieving an early IPF diagnosis, as, in all cases, it revealed established, specific, fibrotic alterations, already classifiable as UIP,when CT changes were still limited and not specific. In light of the significant prognostic implications, lung biopsy should be considered as a valuable and safe tool, especially in this setting. <fig><object-id>erj;64/suppl_68/PA1547/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <fig><object-id>erj;64/suppl_68/PA1547/F2</object-id><object-id>F2</object-id><object-id>F2</object-id><graphic></graphic></fig>