Histopathological Patterns of Lung and Pleural Diseases: A Cross-sectional Study

Introduction: Lung diseases, including lung cancers, are prevalent and deadly worldwide, especially in India. Lung biopsies are crucial for diagnosing pulmonary conditions when non invasive methods are inconclusive. Histopathological examination of biopsy samples provides vital insights for accurate diagnosis and effective treatment planning. Aim: To evaluate the frequency of various histopathological lung lesions detected through biopsy and to assess the demographic and clinical characteristics of patients with lung pathologies. Materials and Methods: This cross-sectional, retrospective study was conducted over a period of 12 months (August 2023 to July 2024) at a tertiary care hospital in Ahmedabad, Gujarat, India. It included 50 patients who underwent lung or pleural biopsies. Patient demographics (age and gender) and clinical features were recorded. The anatomical location (topography) and types of biopsies performed were also evaluated. Histopathological evaluation was done to determine the frequency of neoplastic and non neoplastic lesions. Data were analysed using Microsoft Excel (version 2021). Descriptive statistics and Chi-square tests were applied as appropriate. Results: The cohort consisted of 50 cases who underwent lung biopsy consisted of 32 males and 18 females, with a mean age of 55.18 years. The most common symptoms were cough in 40 (80%), expectoration in 36 (72%) and breathlessness in 30 (60%). A smoking history was noted in 26 (80%) males. Most biopsies were lung-based, predominantly transbronchial in 30 (60%). Histopathologically, 25 (50%) had non neoplastic lesions, including non specific inflammation 16 (64%), granulomatous inflammation indicative of tuberculosis 4 (16%), fungal infection in 2 (8%), reactive mesothelial hyperplasia in 2 (8%), and interstitial fibrosis in 1 (4%). Neoplastic lesions were found in 24 (48%) cases, with Squamous Cell Carcinoma (SCC) being the most frequent in 8 (33%), followed by non small cell lung carcinoma in 5 (21%), adenocarcinoma in 3 (12.5%), small cell carcinoma 3 (12.5%) and solitary fibrous tumour in 1 (4%). Other findings included atypical cells suspicious of malignancy, highgrade bronchial dysplasia, and metastatic carcinoma. Gender differences were statistically significant in both non neoplastic (p-value=0.037) and neoplastic lesions (p-value=0.016). Conclusion: Histopathological examination of lung biopsy specimens plays a crucial role in the accurate diagnosis of various lung diseases, including infections, inflammation, and cancers. Minimally invasive techniques like transbronchial and imaging-guided needle biopsies provide essential tissue samples, enabling early and precise diagnosis. This facilitates tailored treatment plans, ultimately improving patient outcomes and prognosis.