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Ann Thorac Surg 1987;44:269-273
© 1987 The Society of Thoracic Surgeons

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Articles

Lingular and Right Middle Lobe Biopsy in the Assessment of Diffuse Lung Disease

Departments of Pathology and Radiology, and the Divisions of Thoracic Surgery and Respiratory Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada

Accepted for publication February 10, 1987.

^* Address reprint requests to Dr. Miller, Department of Pathology, Vancouver General Hospital, 855 W 12th Ave, Vancouver, BC, Canada V5Z 1M9.

It has been said that the lingula and right middle lobe should be avoided for open-lung biopsy because of nonspecific fibrosis and vascular changes. To determine if the diagnostic yields of lingular or right middle lobe biopsy specimens were unsatisfactory, we reviewed the results of open-lung biopsy in 73 adult patients; 26 were immunocompromised and 47, nonimmunocompromised. We found no evidence to suggest that these two sites were inherently inferior. In 20 of the nonimmuno-compromised patients, computed tomography was performed prior to biopsy, and demonstrated no particular tendency for greater involvement of the lingula or right middle lobe. We conclude that lingular and right middle lobe biopsy is useful in the diagnosis of parenchymal lung disease and that these sites should not necessarily be avoided. Computed tomographic scanning prior to biopsy is helpful in guiding the surgeon to the appropriate sites from which to obtain biopsy specimens.

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