Lung Biopsy for chILD Syndrome

Sometimes, to make an accurate diagnosis, doctors need to remove a tiny piece of lung tissue and study it under a microscope. A lung biopsy is a surgical procedure performed under anesthesia to minimize discomfort.

Currently, the gold standard for the diagnosis of a specific children’s interstitial lung disease (chILD) disorder usually involves obtaining a lung biopsy. As leaders in the chILD Clinical Research Cooperative, our doctors are actively working to develop other diagnostic tools to avoid lung biopsy. We are making good progress, but in most cases a lung biopsy may still be needed.

Why Choose The Children’s Hospital?

The Children’s Hospital is an experienced world leader for lung biopsies in infants, children and adolescents. Our talented surgeons do the least invasive video assisted thoracoscopy (VATS) procedure with excellent outcomes. All patients will require a hospital admission, but many patients can be discharged in less than 48 hours after the operation. Pain is also minimized by avoiding the use of a chest tube after the procedure.

Our chILD team interacts with both the surgical and pathology team about the child’s case and what we want our goals are for the biopsy. As a leading chILD center, we process the biopsies and have the tissue read by the best ILD pathologists.

Questions to Ask Your Doctor

The decision to have your child undergo a lung biopsy is one that requires a review with your pediatric pulmonologists of the risk and benefits. A few questions that might be helpful to understand before making your decision could include the following. Making sure that the location you choose to have the lung biopsy done is the best place for your child is critically important.

• Has a complete evaluation been completed to rule out other underlying diagnoses that could be excluded by other testing before a lung biopsy should be completed?
• Does the child meet the criteria for chILD syndrome, which includes excluding a list of other diagnoses?
• Would the lung biopsy be completed using a video assisted thoracoscopy (VATS) or open lung procedure? If the procedure will be completed using an open lung procedure-what is the rationale for this approach and why isn’t a VATS being considered?
• How many lung biopsies has the institution or surgeon completed in children the age of your child?
• Does the pathologist and institution understand the recommended processing procedures and evaluation for the lung biopsy tissue that the chILD Research Cooperative and Pathology working group has proposed?
• What is the anticipated hospital stay for your child? And what has been the hospital stay for others undergoing a lung biopsy?
• What is the information the physician is trying to obtain from doing lung biopsy? And how likely is it to be found?
• Will a pathologist with experience in the chILD Clinical Research Cooperative classification system be reviewing the lung tissue? If not, can the slides of the tissue be sent to a pathologist with experience diagnosing chILD?