Background: In new years.

Background: In new years, fiberoptic bronchoscopy has been introduced luckily in the research of bronchial asthma. Bronchial biopsy specimens obtained from this procedure are small, and an optimal biopsy technique is necessary to obtain high-quality tissue samples, as sufficient continuance of intact basement membrane and sufficient stillness of submucosal tissue are required.

Methods: We compared size and qualitative aspects of bronchial biopsy specimens from nonasthmatic controls obtained by forceps of three different sizes, marks FB-19C, FB-21C, and FB-35C (Olympus; Tokyo, Japan). conclusions and conclusions: We conclude from this thought that the hypothesis that the bigger the biopsy forceps, the larger the biopsy specimen and the better the quality of the tissue does not imprison Bronchial biopsy specimens obtained with forceps stamp FB-35C and FB-21C were equal in size, still the FB-35C biopsy specimens showed more damage and crush artifacts, whereas biopsy specimens obtained with forceps representation FB-21C had more intact basement membrane, more submucosal midst and well-preserved morphology. (CHEST 1998; 113:182-85)

Key words: asthma; bronchial biopsies; fiberoptic bronchoscopy; forceps size

Abbreviations: BM=basement membrane

Fiberoptic bronchoscopy is at at hand a routine diagnostic procedure in pulmonary diseases. In novel years, this procedure has been introduced in the research of pathophysiologic mechanisms of bronchial asthma.[1,2] It appears to be a safe operation even in patients with bronchial obstructive disease.[3] With the forceps generally used, the biopsy specimens have a diameter of approximately 2 mm[45] The diagnostic utility of these tissue samples is limited by means of their small size, which may proceed in several technical problems. First, there is a cheap yield of sections per biopsy specimen. inferior the mechanical damage of the biopsy specimen according to the forceps used causes difficulties in interpretation of the anatomic edifice of the bronchial mucosa and the histopathologic changes. Finally, epithelium and epithelial basement membrane are not always existing and examination of the submucosa is hampered if there is no recognizable basement membrane (BM)

The aim of this application of mind is to compare biopsy specimens of bronchial mucosa taken with three emblems of biopsy forceps. We compared the size of the biopsy specimen, the morphologic appearance, and the stretch of mechanical damage.

MATERIALS AND METHODS

Thirty patients who had a diagnostic fiberoptic bronchoscopy for various reasons, eg suspected bronchial carcinoma, sarcoidosis, and infectious lung disease, participated in the thought Written informed consent was obtained from all patients and the thought was approved by the Medical Ethics Committee of the University Hospital. Apart from the biopsy specimens privationed for diagnostic procedures, two more biopsy specimens of macroscopically normal bronchial mucosa were taken from subcarinae of the left or right lower lobe. A fiberoptic bronchoscope archetype BF P20 or BF XT20 (Olympus; Tokyo, Japan) and three different fenestrated biopsy forceps were used (Fig 1): FB-19C FB-21C and FB-35C (Olympus). The patients were randomly assigned to the adumbration of biopsy forceps used. Each patient had a biopsy using single of these forceps. Each model of biopsy forceps was used in 10 patients.

[Figure 1 ILLUSTRATION OMITTED]

Mucosal biopsy specimens were immediately transported to the laboratory upon a slide in a humidified, ice-cooled container, and subsequently embedded (in TissueTek; Sakura Finetek USA; Torrance, Calif) and snap-frozen according to immersing in precooled isopentane at -80 [degrees] C Sections were intersect at 4 [micro]m and stored at -80 [degrees] C until use. To evaluate the morphologic architecture of the bronchial tissue, the sections were stained in intervals of 50 [micro]m with Mayer's hematoxylin-eosin. The largest section of a series of 20 serial sections was pick outed for size estimation. Size of the tissue was estimated using an eyepiece graticule (double square lattice with cross-points each 100 [micro]m at x80 magnification), counting the number of points covering morphologically intact tissue.[6] Morphology was assessed from the aspect of the epithelium, the BM and the intactness of the submucosa. Crush artifacts and disruption of tissue are defined as any disruption of tissue leading to inaccurate determination of solitary abode; squalid counts per area. These were considered relevant when causing [is greater than] 10% false increase or decrease of tissue area in which small room counting is to be performed (false increase in surface area is observ in case of edema and diffuse disruption, whereas crush artifacts are mainly responsible for false decrease of real biopsy area).

The biopsy specimens were assessed in a blinded fashion. The Mann-Whitney U exhibition was used to compare among the three form into groupss the number of grid crossings covering morphologically intact tissue. The [chi square]-test was used to compare the intactness of the submucosa and the integrity of the epithelium. Statistical analysis was performed with a statistical package (SPSS/PC+ v 401; SPS Inc; Chicago); p values [is les than] 005 were considered statistically significant.

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