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Fibrotic interstitial lung disease (fILD) is an umbrella term that includes primary and secondary processes with various histologies that often have overlapping clinical and radiographic features. Diagnosing fILD can be challenging, and when more information would have therapeutic implications, biopsy is considered. This state-of-the-art document, created by an international multidisciplinary group, reviews biopsy indications and contraindications, procedural techniques, and patient perspectives.
Diagnostic yield is low with transbronchial biopsy (<30%), higher with the more complex transbronchial cryobiopsy that usually requires intubation and deep sedation (>80%), and highest with surgical biopsy (>90%). However, those three proc…