Should we abandon standard forceps biopsy to diagnose an endobronchial lesion?

The diagnostic yield of flexible bronchoscopy with direct standard forceps biopsy ranges from 72% to 82% in large (>200 patients) case series of patients with endobronchial visible tumours presenting as an exophytic mass or submucosal lesion [1]. At least three endobronchial forceps biopsy samples are recommended at the risk of mild self-limiting (10%) or severe life-threatening ( 90% [3, 4]. A flexible cryoprobe (ERBE USA, Inc., Marietta, GA, USA) for use within a flexible bronchoscope was introduced in 1994. Shortly thereafter, Mathur et al. [5] and Vergnon et al . [6] described its application in the treatment of malignant airway obstruction (palliation) and radio-occult early-stage lung cancer (cure) applying multiple …