Table 4. Indications and techniques of lung biopsy in patients with suspected idiopathic pulmonary fibrosis (IPF)
IndicationAbsence of HRCT features sufficient to diagnose IPF#
SettingSurgical centre experienced in the management of interstitial lung diseases and in performing video-assisted surgical lung biopsies
TechniqueVideo-assisted surgery whenever possible (excluding transbronchial biopsies)
SamplingIn depth, in several lobes+, avoiding the extremity of the lingula and middle lobe
  • HRCT: high-resolution computed tomography. #: theoretical indication, to be balanced during multidisciplinary team discussion with risk associated with biopsy, age and possible comorbid conditions, and to be discussed with the patient; : to collect samples of an adequate size; +: lesions may differ between the lobes.