Archive for the ‘Transbronchial Biopsy’ Category

TBB is often recommended to “rule out” an alternative diagnosis in the clinical setting of FL. We challenge this recommendation. First, the results of our analysis showed that as much as 48.6% of the TBB specimens were read as nonspecific. Second, even when an alternate diagnosis (such as sarcoidosis) was made, FL could not always […]

Converting Pretest to Posttest Probabilities The figures presented in Table 4 were derived from the nomogram of Fagan (Fig 2). Low (25%), intermediate (50%), and high (75%) pretest probabilities were arbitrarily selected to illustrate their modification by any given test results. The presence of diffuse lymphocytic infiltration (which was associated with a likelihood ratio of […]

Contingency tables for the pathologic criteria are given in Table 2. For simplicity, the results obtained from only one pathologist (R.S.F.) are reported since both pathologists graded interstitial infiltrations on slightly different scales. As a pathologic criterion, diffuse lymphocytic infiltration proved useful to generate positive changes in pretest probabilities: when present (graded > 1/3), this […]

Results Diagnostic Distribution A blinded analysis of 105 TBB specimens was performed, the pathologists knowing that there were cases of FL but not the absolute number. Fifty-five of the TBB specimens were from patients with FL. Distribution of diseases from the remaining 50 specimens forming the control group was as follows: sarcoidosis, 21 cases; infectious […]

Interobserver Agreement: Since the two pathologists graded interstitial infiltrations on slightly different scales, Pearson’s coefficients of correlation (r) were reported as a measure of relatedness, instead of kappa as a measure of concordance. We acknowledge that Pearson’s coefficient of correlation is usually higher than any other measure of reliability. However, it usually approximates other intraclass […]

The analysis of the biopsy specimens for each criterion was performed according to the following scales. First, granulomas were graded on a 0- to 2-point scale (0/2: no granuloma found; 1/2: presence of isolated multinucleated giant cells or of loose (poorly circumscribed) clusters of epithelioid cells; 2/2: well-organized granulomas). Second, diffuse lymphocytic infiltration was graded […]

Material: FL vs Control Group Pathologic specimens obtained between 1980 and 1993 from consecutive patients who had TBBs when initially investigated during an acute phase of FL were selected. The FL specimens were matched to TBB specimens from patients with diffuse parenchymal diseases other than hypersensitivity pneumonitis. These control cases were randomly selected by a […]