Alveolar herniation in transbronchial lung biopsy: a newly recognized diagnostic pitfall

Abstract

Artifacts in transbronchial lung biopsy (TBLB) related to the procedure or subsequent handling are well described in the literature, and some may lead to a misdiagnosis of non-small cell lung cancer (NSCLC). ^1,2,3 We report a series of 8 cases with another, yet undescribed artifact consisting of displacement of alveolar pneumocytes and macrophages into the bronchial mucosa posing a diagnostic challenge to distinguish it from lung cancer. The 5 men and 3 women aged between 36 and 82 years had a suspected clinical diagnosis of ILD (4x), diffuse ground glass opacities (2x) or bilateral pulmonary nodules (2x), respectively, with no clinical suspicion of lung cancer.

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