Transbronchial peripheral forceps biopsy without direct guidance in suspected pulmonary oncological lesions – analysis of 189 consecutive patients

<bold>Objective:</bold> To evaluate the randament of transbronchial peripheral lung biopsy procedure in patients with suspected lung malignancies. <bold>Methods:</bold> Between January 2015 and December 2021 (7 years), a total of 189 patients received transbronchial biopsies, with no CT or endoechographic guidance; these procedures represent approximatively 5% of all bronschoscopies performed in that time interval. <bold>Results:</bold> The 189 patients were 119 male and 70 female; some of them received TBBx in more than one bronchus, resulting in a total of 200 TBBx procedures, 122 right-sided and 78 left-sided. A percent of 50.5% of procedures (101) were performed at the level of the upper lobes. The peripheral transbronchial biopsies were performed at the first endobronchial examination, with biopsy forceps. Usually, 4-6 biopsies were performed with a minimum of 2 and a maximum of 8 transbronchial biopsies. The pathology diagnosis was obtained in 108 patients out of 189 – diagnostic yield of 57.14%. In localised lesions (not diffuse), the diagnostic yield for transbronchial biopsy was 54.8% (97 pathological confirmation out of 177 cases). The succesfull diagnosis in pulmonary malignant diseases (91 patients) revealed primary lung cancer in 81 cases and lung metastasis in 10 patients. <bold>Conclusions:</bold> Besides diagnostic procedures as CT-guided biopsy or EBUS-TBNA, unguided (or blind) transbronchial peripheral biopsy in patients suspected with intrathoracic malignancies (with normal endobronchial aspects) should be used when needed, offering a very good diagnostic yield of 57.14%.