Which procedures are performed in the diagnosis of diffuse parenchymal lung diseases (DPLDs)?

Updated: Sep 15, 2020
  • Author: Eleanor M Summerhill, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Bronchiolar lavage findings are frequently abnormal although generally not diagnostic. Bronchiolar lavage is useful in evaluating the possibility of infection or malignancy. It can also be diagnostic for eosinophilic pneumonia. [6]

Transbronchial and endobronchial lung biopsies may be diagnostic, particularly for sarcoidosis or lymphangitic spread of carcinoma but frequently are not useful for other diagnoses. This is due to the patchy distribution of the majority of these diseases.

Many patients require open or thoracoscopic lung biopsy to establish a definitive diagnosis. Currently, video-assisted thoracoscopic lung biopsy is the preferred method.

The role of lung biopsy in the setting of high-resolution CT scan findings characteristic of specific disease entities remains controversial, with expert opinion weighing in on both sides. [4, 5, 7] Consensus appears to be building on the side of forgoing biopsy when the typical clinical and high-resolution CT scan features of UIP/IPF are present.


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