Prélèvements des pneumopathies interstitielles diffuses : du LBA à la cryobiopsie

The gold standard for interstitial lung disease diagnosis is the anatomopathological examination of a surgical biopsy. However this invasive test is not always achievable and there are less invasive alternative tests. Broncho alveolar lavage is not pathognomonic in most interstitial lung diseases yet it will bring arguments in favor of a diagnosis. In idiopathic pulmonary fibrosis, it will show a mixed pattern, while in nonspecific interstital pneumonias and hypersensitivity pneumonias the pattern will be more lymphocytic. However, this pattern, non-specific, could vary depending on the fibrosis level and could not be discriminating for patients with a high level fibrosis. Transbronchial biopsies have a low diagnostic performance for the idiopathic pulmonary fibrosis and non-specific interstitial lung diseases. Cryobiopsy is a promising technique with a good diagnostic performance, still lower than surgical biopsy yet with lower morbidity-mortality