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

T he 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 (,0.02%) bleeding [2]. The addition of endobronchial needle aspiration to endobronchial forceps biopsy at first bronchoscopy or a repeat flexible bronchoscopy with endobronchial forceps biopsy increases the diagnostic yield to .90% [3, 4].