Open lung biopsy for diffuse interstitial lung disease in children

The aim of the study was to investigate the contribution that open lung bio psy makes to the management of children with diffuse interstitial lung dise ase and to review the procedure-related morbidity in comparison with publis hed literature on other biopsy techniques. The authors reviewed the case notes and histology of patients under 18 yrs who had had an open lung biopsy in 1991-1998 for investigation of diffuse i nterstitial lung disease. The majority of patients returned from theatre breathing spontaneously and without an intercostal drain. Three out of 27 suffered a complication relat ed to the biopsy that required intervention. A clear histological diagnosis was reached in 25/27 patients resulting in a change of management in 15/27 . The most common histological patterns were nonspecific interstitial pneum onitis which generally had a favourable prognosis and follicular bronchioli tis/lymphocytic interstitial pneumonitis where prognosis was largely depend ent on that of an underlying systemic disorder. It is concluded that open lung biopsy makes a substantial contribution to t he management of diffuse interstitial lung disease in children and consider ing both diagnostic yield and safety, remains the biopsy technique of choic e.