Transbronchial biopsy

Educational Material:
- Medscape: Transbronchial biopsy, Raghukumar D Thirumala, Zab Mosenifar
- Bronchoscopic visualization of the alveoli. Nishimura N et al. J Bronchology Interv Pulmonol 2014;21(3):227-9
- The effect of cup versus alligator forceps on the results of transbronchial lung biopsy. Jabbardarjani H et al. J Bronchology Interv Pulmonol 2010;17(2):117-21

Fluoroscopic image of tranbronchial biopsy forceps.
-The forceps is advanced to the periphery of the lung until resistance is encountered.
-It is withdrawn by approximately 1 cm.
-The jaws are opened and advanced slightly to obtain the sample of the lung, close to the area where resistance was previously observed.
-The jaws are closed (if the patient experiences pain, the forceps should be opened and withdrawn, as pain indicates contact with the visceral pleura)
-The forceps is retracted firmly
-The sample is placed in formalin and sent to the pathology laboratory

Ideally, 4-6 samples are obtained (at least 1 sample containing full-thickness bronchial mucosa and some alveolar parenchyma)
Bleeding and pneumothorax are the main complications