Chest
Volume 113, Issue 1, January 1998, Pages 182-185
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Laboratory and Animal Investigations
Techniques in Human Airway Inflammation: Quantity and Morphology of Bronchial Biopsy Specimens Taken by Forceps of Three Sizes

https://doi.org/10.1378/chest.113.1.182Get rights and content

Background

In recent years, fiberoptic bronchoscopy has been introduced successfully in the research of bronchial asthma. Bronchial biopsy specimens obtained by this procedure are small, and an optimal biopsy technique is necessary to obtain high-quality tissue samples, as sufficient length of intact basement membrane and sufficient depth of submucosal tissue are required.

Methods

We compared size and qualitative aspects of bronchial biopsy specimens from nonasthmatic subjects, obtained by forceps of three different sizes, types FB-19C, FB-21C, and FB-35C (Olympus; Tokyo, Japan).

Results and conclusions

We conclude from this study that the hypothesis that the bigger the biopsy forceps, the larger the biopsy specimen and the better the quality of the tissue does not hold. Bronchial biopsy specimens obtained with forceps type FB-35C and FB-21C were equal in size, but the FB-35C biopsy specimens showed more damage and crush artifacts, whereas biopsy specimens obtained with forceps type FB-21C had more intact basement membrane, more submucosal depth, and well-preserved morphology.

Section snippets

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 study. Written informed consent was obtained from all patients and the study was approved by the Medical Ethics Committee of the University Hospital. Apart from the biopsy specimens needed for diagnostic procedures, two more biopsy specimens of macroscopically normal bronchial mucosa were taken from subcarinae of the

Results

Biopsy specimens from five patients could not be evaluated. They contained only mucus or blood without tissue (two with forceps type FB-19C, two with FB-35C); biopsy specimens of another patient could not be used due to technical artifacts (FB-19C). Thus, bronchial biopsy specimens of 25 patients were available for evaluation.

The biopsy specimens taken with the FB-35C and FB-21C forceps were equal in size, and the biopsy specimens taken with the FB-19C were the smallest, when measured by the

Discussion

Our study shows that the hypothesis that the bigger the biopsy forceps, the larger the biopsy specimen and the better the quality of the tissue, holds only partially. The FB-19C forceps is the smallest and so are the biopsy specimens taken with it. The jaws of the forceps FB-35C were much larger than the jaws of the other forceps types. It was, however, often difficult to place the FB-35C in the right position on the subcarina of the basal segments. When the forceps were closed, the jaws

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Supported by the Netherlands Asthma Foundation (grant No. 92.28).

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