[Surgical pulmonary biopsy in children].

During the last 2 years an open lung biopsy was performed in 16 children aged from 2 to 14 years. Fourteen of these had a chemotherapeutic induced immunodeficiency and a radiological picture of diffuse pulmonary infiltrate. A definite diagnosis was established in 11 cases: 5 pneumocystis carinii pneumonitis, 2 CMV infections, 2 pneumocalcinosis, 1 neoplastic pulmonary lymphangitis and 1 staphylococcal infection. Three had a non-specific interstitial pneumonitis. In this series there was no post-operative death and the single complication was a wound infection. The tracheal tube could be removed within the hours following the intervention in 14 of the 16 children. The review of the recent literature suggests that the open lung biopsy is a safe and accurate way for the diagnosis of pulmonary infiltrates in pediatric immunocompromised patients. It is however a very invasive procedure and it is expectable that in the next year the bronchoalveolar lavage with a fiberoptic flexible bronchoscope will be systematically attempted prior to the open biopsy.