Biopsy of Lungs and Pleura in Hematologic Center

SR Karagyulyan, KI Danishyan, VS Shavlokhov, MA Silaev, GM Galstyan, AV Tochenov, LA Kuz’mina, IV Efimov, SA Shutov, YuV Pliskunova, IA Shupletsova, AM Kovrigina

Hematology Research Center, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Maksim Anatol’evich Silaev, PhD, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; Tel.: +7(495)612-61-91; e-mail: max-blood@mail.ru

For citation: Karagyulyan SR, Danishyan KI, Shavlokhov VS, et al. Biopsy of Lungs and Pleura in Hematologic Center. Clinical oncohematology. 2016;9(1):42–7 (In Russ).

DOI: 10.21320/2500-2139-2016-9-1-42-47


ABSTRACT

Background & Aims. Morphological, immunohistochemical, immunophenotypic, cytogenetic, molecular and genetic and other examinations of tissues affected by oncohematological diseases are obligatory. The aim of this paper is to evaluate findings of lung and pleura biopsies in different medical conditions using two basic techniques: thoracoscopy and diagnostic thoracotomy.

Methods. Results of morphological examination of lung lesions in patients hospitalized in the Hematology Research Center under the Ministry of Health of the Russian Federation are presented. From 2004 till 2014, 76 biopsies of lung and/or parietal pleura were performed in 73 patients aged 19–77 years via thoracoscopic (48) and/or thoracotomic (28) approach.

Results. No thoracoscopy- and thoracotomy-related complications were observed. Bioptate examinations proved to be informative in 66 (86.7%) patients. Lung lesions were most common in lymphoproliferative diseases. Lung involvement in cancer or metastases was twice as common as it has been expected before the biopsy. On the contrary, expected tuberculosis nature of lung lesions in 5 patients was confirmed only in 2 of them. In 18 cases (23.7 %), the cause of lung lesion was other than the expected one, and appropriate adjustments of the therapy were made.

Conclusion. New less invasive methods of biopsy combined with complex laboratory diagnosing comply with current requirements and permit making a correct diagnosis of a pathological process located in lungs.


Keywords: lung biopsy, thoracoscopy, lung lesion, morphological verification, acute respiratory insufficiency.

Received: August 28, 2015

Accepted: December 26, 2015

Read in PDF (RUS)pdficon


REFERENCES

  1. Атлас. Опухоли лимфатической системы. Под ред. А.И. Воробьева, А.М. Кременецкой. М.: Ньюдиамед, 2007. 294 с.
    [Vorob’eva AI, Kremenetskaya AM, eds. Atlas. Opukholi limfaticheskoi sistemy. (Atlas. Neoplasms of the lymphatic system.) Moscow: Newdiamed Publ.; 2007. 294 p. (In Russ)]
  2. Галстян Г.М. Септический шок и острая дыхательная недостаточность в гематологической клинике: Дис. ¼ д-ра мед. наук. М., 2003.
    [Galstyan GM. Septicheskii shok i ostraya dykhatel’naya nedostatochnost’ v gematologicheskoi klinike. (Septic shock and acute respiratory insufficiency in hematologic clinic.) [dissertation] Moscow; 2003. (In Russ)]
  3. Шулутко Е.М., Городецкий В.М., Галстян Г.М. и др. Биопсия легкого в диагностике причин поражений легких у больных гемобластозами. Терапевтический архив. 2003;10:57–64.
    [Shulutko EM, Gorodetskii VM, Galstyan GM, et al. Lung biopsy in diagnosing causes of lung lesions in patients with hemoblastoses. Terapevticheskii arkhiv. 2003;10:57–64. (In Russ)]
  4. Городецкий В.М., Галстян Г.М., Савченко В.Г. и др. Поражения легких при острой дыхательной недостаточности у больных с депрессиями кроветворения. Терапевтический архив. 2002;4:25–35.
    [Gorodetskii VM, Galstyan GM, Savchenko VG, et al. Lung lesions in acute respiratory insufficiency in patients with suppressed hemapoiesis. Terapevticheskii arkhiv. 2002;4:25–35. (In Russ)]
  5. Patriarca F, Skert C, Sperotto A, et al. Incidence, outcome, and risk factors of late-onset noninfectious pulmonary complications after unrelated donor stem cell transplantation. Bone Marrow Transplant. 2004;33:751–8. doi: 10.1038/sj.bmt.1704426.
  6. Савченко В.Г., Паровичникова Е.Н. Лечение острых лейкозов. М.: МЕДпресс-информ, 2004. С. 95.
    [Savchenko VG, Parovichnikova EN. Lechenie ostrykh leikozov. (Treatment of acute leukemias.) Moscow: MEDpress-inform Publ.; 2004. p. 95. (In Russ)]
  7. Frankel SR, Fardley A, Lawers G, et al. The “retinoic acid syndrome” in acute promyelocytic leukemia. Ann Intern Med. 1992;117(4):292–6. doi: 10.7326/0003-4819-117-4-292.
  8. Larson RS, Tallman MS. Retinoic acid syndrome: manifestations, pathogenesis, and treatment. Best Pract Res Clin Haematol. 2003;16(3):453–61. doi: 10.1016/s1521-6926(03)00043-4.
  9. De Botton S, Dombret H, Sanz M. Incidence, clinical features, and outcome of all trans-retinoic acid syndrome in 413 cases of newly diagnosed acute promyelocytic leukemia. The European APL Group. Blood. 1998;92(8):2712–8.
  10. Montesinos P, Sanz MA. The Differentiation Syndrome in Patients with Acute Promyelocytic Leukemia: Experience of the Pethema Group and Review of the Literature. Mediterr J Hematol Infect Dis. 2011;3(1):e2011059. doi: 10.4084/mjhid.2011.059.
  11. Шавлохов В.С. Хирургические вмешательства в диагностике и терапии лимфатических опухолей средостения и легких: Дис. ¼ д-ра мед. наук. М., 2009.
    [Shavlokhov VS. Khirurgicheskie vmeshatel’stva v diagnostike i terapii limfaticheskikh opukholei sredosteniya i legkikh. (Surgical interventions in diagnosing and therapy of lymphatic neoplasms in mediastinum and lungs.) [dissertation] Moscow; 2009. (In Russ)]
  12. Баркаган З.С. Геморрагические заболевания и синдромы. М.: Медицина, 1988. 528 с.
    [Barkagan ZS. Gemorragicheskie zabolevaniya i sindromy. (Hemorrhagic diseases and syndromes.) Moscow: Meditsina Publ.; 1988. 528 p. (In Russ)]
  13. Freudenberger TD, Madtes DK, Curtis JR, et al. Association between acute and chronic graft-versus-host disease and bronchiolitis obliterans organizing pneumonia in recipients of hematopoietic stem cell transplants. Blood. 2003;102:3822–8. doi: 10.1182/blood-2002-06-1813.
  14. Holbro A, Lehmann T, Girsberger S, et al. Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2013;19:973–80. doi: 10.1016/j.bbmt.2013.03.017.