Imaging description

Transbronchial biopsy can be used to make diagnoses on suspected lung disease and can also be used as surveillance in lung transplant patients to detect clinically silent rejection or infection of the transplanted lung. The transbronchial biopsy can result in visible injury to the lung on the chest radiograph or CT [1–3]. The most common finding in transbronchial biopsy lung injury is a pulmonary nodule. The nodule may have a surrounding halo of ground-glass attenuation and may also be cavitated (Figures 13.1 and 13.2). Most commonly only a single nodule is seen, but multiple nodules can be present (Figure 13.3). There can also be associated areas of ground-glass attenuation which may be due to hemorrhage or due to residual fluid from the bronchoalveolar lavage (BAL) that is typically performed in addition to the biopsy. The nodules secondary to transbronchial biopsy can be present for up to 30 days post biopsy [1].

Importance

Nodules are a nonspecific finding on CT chest and can be due to a number of causes. In the setting of lung transplant, the presence of pulmonary nodules would be suggestive of infection. However, it is important to be aware of the clinical history and any recent transbronchial biopsy in order to suggest the possibility of biopsy injury.