Transbronchial biopsy in diffuse lung disease.

A an initial diagnostic procedure in diffuse and localized lung disease, transbronchial lung biopsy ( TBB ) offers an attractive alternative to open lung biopsy. In the past, TBB was carried out by inserting a flexible forceps through a rigid, opentube bronchoscope or a catheter.’5 More recently, this technique has been popularized by passing the forceps through the channel of a flexible fiberoptic bronchoscope.6 6 Improvement in design of the fiberoptic bronchoscope has greatly facilitated the technique of TBB. Previously, the small biopsy channel severely limited the size of the forceps and, hence, the size of the biopsy specimen. Now the Machida FBS-6TL, Olympus BF-1T, and Pentax FB-19A all have a biopsy channel 2.6 mm in diameter which permits passage of a large “cup” or “crocodile” forceps. Since the biopsy channel of the bronchofiberscope also serves as a route for suction, the effective aspiration of blood, purulent material and secretions is more readily accomplished with the newer fiberoptic instru-