What is the role of lung biopsy in the diagnosis of pulmonary veno-occlusive disease (PVOD)?

Updated: Oct 16, 2018
  • Author: Hakim Azfar Ali, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Surgical lung biopsy in the presence of moderate or severe pulmonary arterial hypertension (PAH) is associated with a significant risk of morbidity and mortality. Although this is a somewhat controversial issue, a surgical lung biopsy in patients with suspected pulmonary veno-occlusive disease (PVOD) also carries a serious risk of morbidity and mortality, particularly in the setting of high pulmonary vascular pressure. [48] Moreover, the results of the biopsy rarely affect PVOD treatment.

Some experts who favor biopsy argue that it provides prognostic information that facilitates decision making with regard to the timing of lung transplantation listing. In the authors’ opinion, however, the risk of surgical lung biopsy outweighs the value and usefulness of the information obtained. Alternative means of assessment, such as CT scan findings and observation of the patient (to determine whether there has been a lack of improvement or continued clinical worsening despite specific PAH therapies), may be used to make decisions about the listing for and timing of lung transplantation.

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