array:22 [
  "pii" => "S0300289615323711"
  "issn" => "03002896"
  "doi" => "10.1016/S0300-2896(15)32371-1"
  "estado" => "S300"
  "fechaPublicacion" => "1982-03-01"
  "aid" => "72441"
  "copyright" => "Sociedad Española de Neumología y Cirugía Torácica"
  "copyrightAnyo" => "1982"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Arch Bronconeumol. 1982;18:61-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1301
    "formatos" => array:3 [
      "EPUB" => 42
      "HTML" => 597
      "PDF" => 662
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0300289615323723"
    "issn" => "03002896"
    "doi" => "10.1016/S0300-2896(15)32372-3"
    "estado" => "S300"
    "fechaPublicacion" => "1982-03-01"
    "aid" => "72442"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 1982;18:69-72"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1377
      "formatos" => array:3 [
        "EPUB" => 63
        "HTML" => 599
        "PDF" => 715
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Carcinoma pulmonar de celula pequeña. Revision de 88 casos y resultados terapeuticos en 48"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "69"
          "paginaFinal" => "72"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Small cell pulmonary carcinoma. A review of 88 cases with a report on results of therapy in 48"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J. Sauret Valet, C. Martinez Garcia, P. Franci Piera, J. Rifa Ferrer, C. Puzo Ardanuy, R. Cornudella"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "J."
              "apellidos" => "Sauret Valet"
            ]
            1 => array:2 [
              "nombre" => "C."
              "apellidos" => "Martinez Garcia"
            ]
            2 => array:2 [
              "nombre" => "P."
              "apellidos" => "Franci Piera"
            ]
            3 => array:2 [
              "nombre" => "J."
              "apellidos" => "Rifa Ferrer"
            ]
            4 => array:2 [
              "nombre" => "C."
              "apellidos" => "Puzo Ardanuy"
            ]
            5 => array:2 [
              "nombre" => "R."
              "apellidos" => "Cornudella"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615323723?idApp=UINPBA00003Z"
    "url" => "/03002896/0000001800000002/v1_201509151137/S0300289615323723/v1_201509151137/es/main.assets"
  ]
  "es" => array:12 [
    "idiomaDefecto" => true
    "titulo" => "Rendimiento diagnostico de la biopsia pulmonar por toracotomia en la enfermedad pulmonar difusa. Resultados sobre 94 casos"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "61"
        "paginaFinal" => "68"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "J. Morera Prat, J. Ruiz Manzano, E. Fite, J. Oriol, L. Bernado, A. Aranda, F. Morell, R. Vidal, C. Plans"
        "autores" => array:9 [
          0 => array:2 [
            "nombre" => "J."
            "apellidos" => "Morera Prat"
          ]
          1 => array:2 [
            "nombre" => "J."
            "apellidos" => "Ruiz Manzano"
          ]
          2 => array:2 [
            "nombre" => "E."
            "apellidos" => "Fite"
          ]
          3 => array:2 [
            "nombre" => "J."
            "apellidos" => "Oriol"
          ]
          4 => array:2 [
            "nombre" => "L."
            "apellidos" => "Bernado"
          ]
          5 => array:2 [
            "nombre" => "A."
            "apellidos" => "Aranda"
          ]
          6 => array:2 [
            "nombre" => "F."
            "apellidos" => "Morell"
          ]
          7 => array:2 [
            "nombre" => "R."
            "apellidos" => "Vidal"
          ]
          8 => array:2 [
            "nombre" => "C."
            "apellidos" => "Plans"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Sección de Neumología. Departamento de Medicina Interna. C. S. Francisco Franco Barcelona"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "The diagnostic uselfuness of pulmonary biopsy by thoracotomy in diffuse pulmonary disease. results in 94 cases"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "1980-04-14"
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="absec0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se ha revisado el rendimiento diagn&#243;stico de la biopsia pulmonar quir&#250;rgica por minitoracotom&#237;a &#40;BPQ&#41; en una serie de 94 pacientes con enfermedad pulmonar difusa &#40;EPD&#41; estudiados en nuestro departamento desde enero de 1973 a diciembre de 1979&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se obtuvo un diagn&#243;stico de certeza en un 91&#44;5 &#37;&#44; y un diagn&#243;stico inespec&#237;fico de un 6&#44;4 &#37;&#46; En un caso &#40;1&#44;1 &#37;&#41; el diagn&#243;stico se consider&#243; incompleto&#44; y en otro caso &#40;1&#44;1 &#37;&#41; no se obtuvo ning&#250;n diagn&#243;stico&#46; En 9 casos &#40;10 &#37;&#41; se obtuvieron otros diagn&#243;sticos de importancia&#44; adicionalmente a los fundamentales&#46; La mortalidad debida al procedimiento fue de un 1&#44;1 &#37;&#46; En m&#225;s del 50 &#37; de los casos el diagn&#243;stico no hab&#237;a sido sospechado&#46; Previamente se hab&#237;an practicado al conjunto de pacientes&#44; 49 exploraciones invasivas que no fueron consideradas diagn&#243;sticas&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estos resultados son parecidos a los obtenidos por otras series de la literatura&#46; Se comentan algunos aspectos de las indicaciones y contraindicaciones&#44; as&#237; como algunas medidas a tomar rutinariamente para aumentar el rendimiento y disminuir el riesgo y morbilidad del procedimiento diagn&#243;stico&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Aunque la publicaci&#243;n no aborda el tema des de un punto de vista quir&#250;rgico&#44; los resultados no son contrarios al empleo de la BPQ en el territorio de la l&#237;ngula&#44; aspecto controvertido en la literatura&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Summary"
        "resumen" => "<span id="absec0010" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The diagnostic valu&#233; of surgical biopsy of the lung through mini-thoracotomy was evaluated in a series of 94 patients with diffuse pulmonary disease who were studied between January 1973 and December 1979&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Definite diagnoses were established in 91&#46;5 &#37; and non-specific diagnoses 6&#46;4 &#37;&#46; In one case &#40;1&#46;1 &#37;&#41; the diagnosis was incomplete while no diagnosis could be established in another one &#40;1&#46;1 &#37;&#41;&#46; In 9 cases &#40;10 &#37;&#41; other processes were diagnosed besides the pulmonary disease&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The mortality rate due to the biopsy was 1&#46;1 &#37;&#46; In more than 50 &#37; of all cases&#44; the diagnoses were unexpected&#46; All 49 patients had undergone invasive explorations without diagnoses being established&#46; These results are in agreement with those of other authors&#46; The indications and contra-indications for lung biopsy&#44; routine measures to increase the effectiveness and routine precautions to reduce risk to the patient are discussed&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Although this report has no direct bearing on surgical procedures&#44; it is noteworthy that these results may be applicable to lingular biopsies&#44; the use of which is still a matter of controvery&#46;</p></span>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:44 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biopsy of diffuse pulmonary lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46;P&#46; Klassen"
                            1 => "A&#46;J&#46; Anylan"
                            2 => "G&#46;M&#46; Curtis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "N Eng J Med"
                        "fecha" => "1949"
                        "volumen" => "59"
                        "paginaInicial" => "694"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La biopsia pleuropulmonar en el diagn&#243;stico de las enlermedades broncopulmonares"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;I&#46; Vara Cuadrado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "III Congreso de Patolog&#237;a Respiratoria&#46; San Sebasti&#225;n"
                        "fecha" => "1970"
                        "paginaInicial" => "115"
                        "paginaFinal" => "173"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biopsia pulmonar quir&#250;rgica en la infancia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Balcells"
                            1 => "J&#46; Boix-Ochoa"
                            2 => "N&#46; Cobos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Rev Esp Ped"
                        "fecha" => "1975"
                        "volumen" => "30"
                        "paginaInicial" => "923"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Letang"
                            1 => "R&#46; Pujol"
                            2 => "A&#46; Roig"
                            3 => "J&#46; Grau"
                            4 => "M&#46; Catal&#225;n"
                            5 => "J&#46; S&#225;nchez Lloret"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "IX Congreso de la SEPAR Sevilla"
                        "fecha" => "1976"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nuestra experiencia con la biopsia pulmonar tras toracotom&#237;a en la insuficiencia respiratoria del adulto"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "I&#46; L&#243;pez Benito"
                            1 => "J&#46; Raxach"
                            2 => "A&#46; Varela Garc&#237;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Medicina Intensiva"
                        "fecha" => "1978"
                        "paginaInicial" => "12"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6&#93;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Letang E&#46; Biopsia pulmonar Medicine &#40;Barcelona&#41; n&#46;&#176; 41 2553-2555"
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Valor de la biopsia pulmonar como m&#233;todo de diagn&#243;stico en pacientes con insuficiencia respiratoria aguda y ventilaci&#243;n mec&#225;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46;<span class="elsevierStyleSup">a</span> Paya"
                            1 => "M&#46; Palomar"
                            2 => "A&#46; Salgado"
                            3 => "J&#46; Klamburg"
                            4 => "J&#46;A&#46; Maestre"
                            5 => "F&#46; Latorre"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "XIV Reuni&#243;n Anual de la Sociedad Espa&#241;ola de Medicina Intensiva y Unidades Coronarias&#46; Toledo"
                        "fecha" => "1979"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic fibroptic bronchoscopy Techniques and results&#58; 600 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;C&#46; Zavala"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1975"
                        "volumen" => "68"
                        "paginaInicial" => "12"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/168036"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La biopsia transbronquial con broncofibroscopio"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;M&#46;<span class="elsevierStyleSup">a</span>&#46; Sauret Valet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Tesis Doctoral&#46; Barcelona&#46; Universidad Aut&#243;noma"
                        "fecha" => "1978"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biopsia transbronquial mediante el broncofibroscopio"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Castella"
                            1 => "L&#46; Mar&#237;n"
                            2 => "C&#46; Puzo"
                            3 => "J&#46; Rubio"
                            4 => "P&#46; Gra&#241;ena"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "1976"
                        "volumen" => "12"
                        "paginaInicial" => "63"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biopsia transbronquial con broncofibroscopio"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "L&#46; Mu&#241;oz D&#237;az"
                            1 => "A&#46; Clariana Pal"
                            2 => "M&#46;<span class="elsevierStyleSup">a</span> Farrerons"
                            3 => "A&#46; Vences"
                            4 => "A&#46; Retamar"
                            5 => "J&#46;P&#46; D&#237;az Jim&#233;nez"
                            6 => "J&#46; Candelas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Med Cl&#236;n"
                        "fecha" => "1976"
                        "volumen" => "67"
                        "paginaInicial" => "256"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biopsia pulmonar transbronquial a trav&#233;s del broncofibroscopio Nuestra experiencia en 64 casos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Calle Del Moral"
                            1 => "de la"
                            2 => "A&#46; Ladaria"
                            3 => "M&#46; Ull"
                            4 => "J&#46; Marcos"
                            5 => "A&#46; Alarc&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Med Clin &#40;Barcelona&#41;"
                        "fecha" => "1978"
                        "volumen" => "70"
                        "paginaInicial" => "99"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "I Reuni&#243;n Nacional de la Sociedad Espa&#241;ola de Patolog&#237;a Respiratoria&#46; &#171;Broncofibroscopia en as enfermedades pulmonares difusas&#187;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; Calle Del Moral"
                            1 => "de la"
                            2 => "E&#46; L&#243;pez Bermejo"
                            3 => "A&#46; Garc&#237;a Molino"
                            4 => "N&#46; Matamoros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Palma de Mallorca"
                        "fecha" => "1979"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung biopsy in he acutelly ill&#46; When and how&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;L&#46; Hughes"
                            1 => "M&#46; Bogdonoff"
                            2 => "L&#46;P&#46; Faber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1972"
                        "volumen" => "62"
                        "paginaInicial" => "484"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4538672"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung biopsy&#58; Transbronchoscopic&#44; percutaneous&#44; open"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46;A&#46; Andersen"
                            1 => "T&#46; Miller"
                            2 => "P&#46;H&#46;E&#46; Bernatz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Surgical clinical of North Am&#233;rica"
                        "fecha" => "1973"
                        "volumen" => "53"
                        "paginaInicial" => "785"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transbroncoscopic lung biopsy in diffuse pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;A&#46; Andersen"
                            1 => "R&#46;S&#46; Fontana"
                            2 => "D&#46;R&#46; Sanderson"
                            3 => "E&#46;G&#46; Harrison"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin N Am"
                        "fecha" => "1970"
                        "volumen" => "54"
                        "paginaInicial" => "951"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5425117"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of transbronchial of the lung"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;E&#46; Fechner"
                            1 => "S&#46;D&#46; Greenberg"
                            2 => "R&#46;K&#46; Wilton"
                            3 => "P&#46;M&#46; Stevens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Clin Pathol"
                        "fecha" => "1977"
                        "volumen" => "68"
                        "paginaInicial" => "17"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/868801"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical-Pathologic approach to diffuse infiltrative lung disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;H&#46;B&#46; Carrington"
                            1 => "E&#46; Gaensler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "&#171;The Lung&#46; Structure&#44; Function and Disease&#187; by Thurlbeck"
                        "paginaInicial" => "58"
                        "paginaFinal" => "87"
                        "serieFecha" => "1978"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Implicaciones cl&#237;nicas de una biopsia transbronquial no espec&#237;fica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;K&#46; Wilson"
                            1 => "R&#46;E&#46; Fechner"
                            2 => "R&#46;E&#46; Greenberg"
                            3 => "R&#46; Estrada"
                            4 => "P&#46; Stevens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "1978"
                        "volumen" => "65"
                        "numero" => "122&#46;"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20&#93;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Carter D&#46; Biopses of the lung&#44; en &#171;Pulmonary System&#46; Practical approach to pulmonary diagnosis&#187; Ed&#46; by Siegelman S&#46; S&#46;&#44; Stilik&#44; F&#46;P&#46;&#44; Summer&#44; W&#46;R&#46; Grune Stratton&#46; New York 1979 141-161"
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21&#93;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Summer W&#46;R&#46; Terry P&#46;B&#46; Approach to the patient with diffuse lung disease&#44; en &#171;Pulmonary System&#46; Practical approach to pulmonary diagnosis&#187;&#46; Ed&#46; by Siegelman&#44; S&#46;S&#46;&#44; Stilik&#44; F&#46;P&#46;&#44; Summer&#44; W&#46;R&#46; Grune-Stratton&#46; New-York 1979 261-307"
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biopsy procedures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46;H&#46;A&#46; Neff"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "&#171;Pulmonary diseases and disorders&#187;"
                        "paginaInicial" => "131"
                        "paginaFinal" => "138"
                        "serieFecha" => "1980"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse pulmonary lesion problems of differential diagnosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;A&#46; Buechner"
                            1 => "C&#46;B&#46; Rahn"
                            2 => "G&#46;W&#46;H&#46; Schepers"
                            3 => "D&#46;M&#46; Spain"
                            4 => "M&#46;M&#46; Ziskind"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1963"
                        "volumen" => "43"
                        "paginaInicial" => "155"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The roentgen diagnosis of disseminated pulmonary alveolar disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46; Felson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "Semin&#46; Roentgenol"
                        "fecha" => "1967"
                        "editorial" => "Greene-Shetton Inc&#46;"
                        "editorialLocalizacion" => "New York"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung biopsy in the diagnosis of diffuse lung disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;G&#46; Scadding"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br Med J"
                        "fecha" => "1970"
                        "volumen" => "2"
                        "paginaInicial" => "557"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/890417"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biopsy of diffuse pulmonary lesions&#58; a 17 year experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;P&#46; Klassen"
                            1 => "N&#46;C&#46; Andrew"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "1967"
                        "volumen" => "4"
                        "paginaInicial" => "117"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6040359"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Open pulmonary biopsy&#58; 19 year experience with consecutive 416 operations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:11 [
                            0 => "J&#46;F&#46; Ray"
                            1 => "B&#46;R&#46; Lawton"
                            2 => "W&#46;O&#46; Myers"
                            3 => "W&#46;M&#46; Toyama"
                            4 => "C&#46;N&#46; Reyes"
                            5 => "A&#46;E&#46; Deam"
                            6 => "J&#46;L&#46; Burns"
                            7 => "D&#46;P&#46; Pederson"
                            8 => "W&#46;V&#46; Dovenbarger"
                            9 => "F&#46;J&#46; Wenzel"
                            10 => "R&#46;D&#46; Sautter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1976"
                        "volumen" => "69"
                        "paginaInicial" => "43"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1244286"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung biopsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;B&#46; Effler"
                            1 => "H&#46;S&#46; Van Ordstrand"
                            2 => "L&#46;J&#46; McCormack"
                            3 => "H&#46;A&#46; Gancedo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Amer Rev Tuberc"
                        "fecha" => "1955"
                        "volumen" => "71"
                        "paginaInicial" => "668"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung biopsy for diffuse pulmonary lesions&#58; value and limitations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;H&#46; Rubin"
                            1 => "M&#46; Rubin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1964"
                        "volumen" => "46"
                        "paginaInicial" => "634"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung biopsy in the diagnosis of the penumoconiosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;A&#46; Theodos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1968"
                        "volumen" => "53"
                        "paginaInicial" => "271"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An evaluation of open lung biopsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;R&#46; Baker"
                            1 => "J&#46;M&#46; Lee"
                            2 => "D&#46; Carter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Hopkins Med J"
                        "fecha" => "1973"
                        "volumen" => "132"
                        "paginaInicial" => "103"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary pathology in acute respiratory insufficiency&#58; Lung biopsy as a diagnostic tool"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "J&#46;D&#46; Hill"
                            1 => "J&#46;L&#46; Ratliff"
                            2 => "J&#46;C&#46;W&#46; Parrott"
                            3 => "M&#46; Lamy"
                            4 => "R&#46;J&#46; Fallat"
                            5 => "E&#46; Koeniger"
                            6 => "G&#46; Whitner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg"
                        "fecha" => "1976"
                        "volumen" => "71"
                        "paginaInicial" => "64"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/765628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Les biopsies pulmonaires &#224; thorax ouvert &#224; 141 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Chretien"
                            1 => "J&#46; Bernadin"
                            2 => "P&#46; Soler"
                            3 => "F&#46; Basset"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Bronchopneumologie"
                        "fecha" => "1976"
                        "volumen" => "26"
                        "paginaInicial" => "191"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung biopsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;W&#46; Shields"
                            1 => "S&#46;K&#46; Sweany"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Surg Gyn and Obst"
                        "fecha" => "1960"
                        "volumen" => "110"
                        "paginaInicial" => "585"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Open lung biopsy in diffuse pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;A&#46; Gaensler"
                            1 => "M&#46;V&#46; Ball-Moister"
                            2 => "J&#46; Hamm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "N Eng J Med"
                        "fecha" => "1964"
                        "volumen" => "270"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fiberoptic bronchoscopy in the diagnosis of sarcoidosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;S&#46; Teirstein"
                            1 => "M&#46;T&#46; Chuang"
                            2 => "A&#46;R&#46; Choy"
                            3 => "A&#46; Miller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Mt&#46; Sinai J Med"
                        "fecha" => "1977"
                        "volumen" => "44"
                        "paginaInicial" => "740"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/304157"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "37&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nongranulomatous interstitial pneumonitis in sarcoidosis relationship to development of epithelioid granulomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;H&#46;J&#46; Rosen"
                            1 => "S&#46;M&#46; Athanassiades"
                            2 => "H&#46;A&#46; Lyons"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1978"
                        "volumen" => "74"
                        "paginaInicial" => "122"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/679737"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "38&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse interstitial pneumonitis&#58; Clinicopathologic correlations in 20 patients treated with prednisoneazathioprine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:10 [
                            0 => "R&#46;H&#46; Winterbauer"
                            1 => "P&#46; Aquimares"
                            2 => "K&#46;O&#46; Hallman"
                            3 => "J&#46;E&#46; Hays"
                            4 => "E&#46; Pardeen"
                            5 => "E&#46;H&#46; Morgan"
                            6 => "J&#46;D&#46; Allen"
                            7 => "K&#46;D&#46; Moore"
                            8 => "W&#46; Busch"
                            9 => "J&#46;H&#46; Walker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "1978"
                        "volumen" => "65"
                        "paginaInicial" => "661"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/707526"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "39&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The end stage lung"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46;P&#46; Genereuh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/116.2.279"
                      "Revista" => array:5 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "1975"
                        "volumen" => "116"
                        "paginaInicial" => "279"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1153728"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "40&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung biopsy How vs&#46; whom&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46;H&#46;A&#46; Neff"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1976"
                        "volumen" => "70"
                        "paginaInicial" => "201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/947683"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "41&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immunofluorescent studies in patients with farmer&#39;s lung"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46;J&#46; Wenzel"
                            1 => "D&#46;A&#46; Emanuel"
                            2 => "R&#46;L&#46; Gray"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Allergy"
                        "fecha" => "1971"
                        "volumen" => "48"
                        "paginaInicial" => "224"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "42&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Circulating immune complexes in the idiophatic interstitial pneumonias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;B&#46; Dreisin"
                            1 => "M&#46;I&#46; Schwarz"
                            2 => "A&#46;N&#46; Theofilopoulos"
                            3 => "R&#46;E&#46; Stanford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "N Eng J Med"
                        "fecha" => "1978"
                        "volumen" => "298"
                        "paginaInicial" => "353"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "43&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification par la microscopie dectronique de particules de nature probablement virales dans les lesions granulomateuses d&#8217;une histyocitose X pulmonaire"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "F&#46; Basset"
                            1 => "M&#46;J&#46; Turiaf"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "CR Acad Sci &#40;Paris&#41;"
                        "fecha" => "1965"
                        "volumen" => "261"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "44&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The detection of etiologics agents in interstitial pulmonary fibrosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;R&#46; Ruttner"
                            1 => "M&#46;A&#46; Spycher"
                            2 => "P&#46;H&#46;D&#46; Sticher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Hum Path"
                        "fecha" => "1973"
                        "volumen" => "4"
                        "paginaInicial" => "497"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4750819"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/03002896/0000001800000002/v1_201509151137/S0300289615323711/v1_201509151137/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9277"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/03002896/0000001800000002/v1_201509151137/S0300289615323711/v1_201509151137/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615323711?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 18. Issue 2.
Pages 61-68 (March - April 1982)
Share
Share
Download PDF
More article options
Vol. 18. Issue 2.
Pages 61-68 (March - April 1982)
Full text access
Rendimiento diagnostico de la biopsia pulmonar por toracotomia en la enfermedad pulmonar difusa. Resultados sobre 94 casos
The diagnostic uselfuness of pulmonary biopsy by thoracotomy in diffuse pulmonary disease. results in 94 cases
Visits
3840
J. Morera Prat, J. Ruiz Manzano, E. Fite, J. Oriol, L. Bernado, A. Aranda, F. Morell, R. Vidal, C. Plans
Sección de Neumología. Departamento de Medicina Interna. C. S. Francisco Franco Barcelona
This item has received
Article information
Resumen

Se ha revisado el rendimiento diagnóstico de la biopsia pulmonar quirúrgica por minitoracotomía (BPQ) en una serie de 94 pacientes con enfermedad pulmonar difusa (EPD) estudiados en nuestro departamento desde enero de 1973 a diciembre de 1979.

Se obtuvo un diagnóstico de certeza en un 91,5 %, y un diagnóstico inespecífico de un 6,4 %. En un caso (1,1 %) el diagnóstico se consideró incompleto, y en otro caso (1,1 %) no se obtuvo ningún diagnóstico. En 9 casos (10 %) se obtuvieron otros diagnósticos de importancia, adicionalmente a los fundamentales. La mortalidad debida al procedimiento fue de un 1,1 %. En más del 50 % de los casos el diagnóstico no había sido sospechado. Previamente se habían practicado al conjunto de pacientes, 49 exploraciones invasivas que no fueron consideradas diagnósticas.

Estos resultados son parecidos a los obtenidos por otras series de la literatura. Se comentan algunos aspectos de las indicaciones y contraindicaciones, así como algunas medidas a tomar rutinariamente para aumentar el rendimiento y disminuir el riesgo y morbilidad del procedimiento diagnóstico.

Aunque la publicación no aborda el tema des de un punto de vista quirúrgico, los resultados no son contrarios al empleo de la BPQ en el territorio de la língula, aspecto controvertido en la literatura.

Summary

The diagnostic valué of surgical biopsy of the lung through mini-thoracotomy was evaluated in a series of 94 patients with diffuse pulmonary disease who were studied between January 1973 and December 1979.

Definite diagnoses were established in 91.5 % and non-specific diagnoses 6.4 %. In one case (1.1 %) the diagnosis was incomplete while no diagnosis could be established in another one (1.1 %). In 9 cases (10 %) other processes were diagnosed besides the pulmonary disease.

The mortality rate due to the biopsy was 1.1 %. In more than 50 % of all cases, the diagnoses were unexpected. All 49 patients had undergone invasive explorations without diagnoses being established. These results are in agreement with those of other authors. The indications and contra-indications for lung biopsy, routine measures to increase the effectiveness and routine precautions to reduce risk to the patient are discussed.

Although this report has no direct bearing on surgical procedures, it is noteworthy that these results may be applicable to lingular biopsies, the use of which is still a matter of controvery.

Full text is only aviable in PDF
Bibliografia
[1.]
K.P. Klassen, A.J. Anylan, G.M. Curtis.
Biopsy of diffuse pulmonary lesions.
N Eng J Med, 59 (1949), pp. 694
[2.]
D.I. Vara Cuadrado.
La biopsia pleuropulmonar en el diagnóstico de las enlermedades broncopulmonares.
III Congreso de Patología Respiratoria. San Sebastián, (1970), pp. 115-173
[3.]
R. Balcells, J. Boix-Ochoa, N. Cobos.
Biopsia pulmonar quirúrgica en la infancia.
Rev Esp Ped, 30 (1975), pp. 923
[4.]
E. Letang, R. Pujol, A. Roig, J. Grau, M. Catalán, J. Sánchez Lloret.
IX Congreso de la SEPAR Sevilla, (1976),
[5.]
I. López Benito, J. Raxach, A. Varela García.
Nuestra experiencia con la biopsia pulmonar tras toracotomía en la insuficiencia respiratoria del adulto.
Medicina Intensiva, (1978), pp. 12
[6]
Letang E. Biopsia pulmonar Medicine (Barcelona) n.° 41 2553-2555
[7.]
J.M.a Paya, M. Palomar, A. Salgado, J. Klamburg, J.A. Maestre, F. Latorre.
Valor de la biopsia pulmonar como método de diagnóstico en pacientes con insuficiencia respiratoria aguda y ventilación mecánica.
XIV Reunión Anual de la Sociedad Española de Medicina Intensiva y Unidades Coronarias. Toledo, (1979),
[8.]
D.C. Zavala.
Diagnostic fibroptic bronchoscopy Techniques and results: 600 patients.
Chest, 68 (1975), pp. 12
[9.]
J.M.a. Sauret Valet.
La biopsia transbronquial con broncofibroscopio.
Tesis Doctoral. Barcelona. Universidad Autónoma, (1978),
[10.]
J. Castella, L. Marín, C. Puzo, J. Rubio, P. Grañena.
Biopsia transbronquial mediante el broncofibroscopio.
Arch Bronconeumol, 12 (1976), pp. 63
[11.]
L. Muñoz Díaz, A. Clariana Pal, M.a Farrerons, A. Vences, A. Retamar, J.P. Díaz Jiménez, J. Candelas.
Biopsia transbronquial con broncofibroscopio.
Med Clìn, 67 (1976), pp. 256
[12.]
F. Calle Del Moral, de la, A. Ladaria, M. Ull, J. Marcos, A. Alarcón.
Biopsia pulmonar transbronquial a través del broncofibroscopio Nuestra experiencia en 64 casos.
Med Clin (Barcelona), 70 (1978), pp. 99
[13.]
F. Calle Del Moral, de la, E. López Bermejo, A. García Molino, N. Matamoros.
I Reunión Nacional de la Sociedad Española de Patología Respiratoria. «Broncofibroscopia en as enfermedades pulmonares difusas».
Palma de Mallorca, (1979),
[14.]
R.L. Hughes, M. Bogdonoff, L.P. Faber.
Lung biopsy in he acutelly ill. When and how?.
Chest, 62 (1972), pp. 484
[15.]
H.A. Andersen, T. Miller, P.H.E. Bernatz.
Lung biopsy: Transbronchoscopic, percutaneous, open.
Surgical clinical of North América, 53 (1973), pp. 785
[16.]
H.A. Andersen, R.S. Fontana, D.R. Sanderson, E.G. Harrison.
Transbroncoscopic lung biopsy in diffuse pulmonary disease.
Med Clin N Am, 54 (1970), pp. 951
[17.]
R.E. Fechner, S.D. Greenberg, R.K. Wilton, P.M. Stevens.
Evaluation of transbronchial of the lung.
Am J Clin Pathol, 68 (1977), pp. 17
[18.]
C.H.B. Carrington, E. Gaensler.
Clinical-Pathologic approach to diffuse infiltrative lung disease.
«The Lung. Structure, Function and Disease» by Thurlbeck, pp. 58-87
[19.]
R.K. Wilson, R.E. Fechner, R.E. Greenberg, R. Estrada, P. Stevens.
Implicaciones clínicas de una biopsia transbronquial no específica.
Am J Med, 65 (1978),
[20]
Carter D. Biopses of the lung, en «Pulmonary System. Practical approach to pulmonary diagnosis» Ed. by Siegelman S. S., Stilik, F.P., Summer, W.R. Grune Stratton. New York 1979 141-161
[21]
Summer W.R. Terry P.B. Approach to the patient with diffuse lung disease, en «Pulmonary System. Practical approach to pulmonary diagnosis». Ed. by Siegelman, S.S., Stilik, F.P., Summer, W.R. Grune-Stratton. New-York 1979 261-307
[22.]
T.H.A. Neff.
Biopsy procedures.
«Pulmonary diseases and disorders», pp. 131-138
[23.]
H.A. Buechner, C.B. Rahn, G.W.H. Schepers, D.M. Spain, M.M. Ziskind.
Diffuse pulmonary lesion problems of differential diagnosis.
Chest, 43 (1963), pp. 155
[24.]
B. Felson.
The roentgen diagnosis of disseminated pulmonary alveolar disease.
Semin. Roentgenol, Greene-Shetton Inc., (1967),
[25.]
J.G. Scadding.
Lung biopsy in the diagnosis of diffuse lung disease.
Br Med J, 2 (1970), pp. 557
[26.]
K.P. Klassen, N.C. Andrew.
Biopsy of diffuse pulmonary lesions: a 17 year experience.
Ann Thorac Surg, 4 (1967), pp. 117
[27.]
J.F. Ray, B.R. Lawton, W.O. Myers, W.M. Toyama, C.N. Reyes, A.E. Deam, J.L. Burns, D.P. Pederson, W.V. Dovenbarger, F.J. Wenzel, R.D. Sautter.
Open pulmonary biopsy: 19 year experience with consecutive 416 operations.
Chest, 69 (1976), pp. 43
[28.]
D.B. Effler, H.S. Van Ordstrand, L.J. McCormack, H.A. Gancedo.
Lung biopsy.
Amer Rev Tuberc, 71 (1955), pp. 668
[29.]
E.H. Rubin, M. Rubin.
Lung biopsy for diffuse pulmonary lesions: value and limitations.
Chest, 46 (1964), pp. 634
[30.]
P.A. Theodos.
Lung biopsy in the diagnosis of the penumoconiosis.
Chest, 53 (1968), pp. 271
[31.]
R.R. Baker, J.M. Lee, D. Carter.
An evaluation of open lung biopsy.
Hopkins Med J, 132 (1973), pp. 103
[32.]
J.D. Hill, J.L. Ratliff, J.C.W. Parrott, M. Lamy, R.J. Fallat, E. Koeniger, G. Whitner.
Pulmonary pathology in acute respiratory insufficiency: Lung biopsy as a diagnostic tool.
J Thorac Cardiovasc Surg, 71 (1976), pp. 64
[33.]
J. Chretien, J. Bernadin, P. Soler, F. Basset.
Les biopsies pulmonaires à thorax ouvert à 141 cases.
Bronchopneumologie, 26 (1976), pp. 191
[34.]
T.W. Shields, S.K. Sweany.
Lung biopsy.
Surg Gyn and Obst, 110 (1960), pp. 585
[35.]
E.A. Gaensler, M.V. Ball-Moister, J. Hamm.
Open lung biopsy in diffuse pulmonary disease.
N Eng J Med, 270 (1964),
[36.]
A.S. Teirstein, M.T. Chuang, A.R. Choy, A. Miller.
Fiberoptic bronchoscopy in the diagnosis of sarcoidosis.
Mt. Sinai J Med, 44 (1977), pp. 740
[37.]
T.H.J. Rosen, S.M. Athanassiades, H.A. Lyons.
Nongranulomatous interstitial pneumonitis in sarcoidosis relationship to development of epithelioid granulomas.
Chest, 74 (1978), pp. 122
[38.]
R.H. Winterbauer, P. Aquimares, K.O. Hallman, J.E. Hays, E. Pardeen, E.H. Morgan, J.D. Allen, K.D. Moore, W. Busch, J.H. Walker.
Diffuse interstitial pneumonitis: Clinicopathologic correlations in 20 patients treated with prednisoneazathioprine.
Am J Med, 65 (1978), pp. 661
[39.]
G.P. Genereuh.
The end stage lung.
Radiology, 116 (1975), pp. 279
[40.]
T.H.A. Neff.
Lung biopsy How vs. whom?.
Chest, 70 (1976), pp. 201
[41.]
F.J. Wenzel, D.A. Emanuel, R.L. Gray.
Immunofluorescent studies in patients with farmer's lung.
J Allergy, 48 (1971), pp. 224
[42.]
R.B. Dreisin, M.I. Schwarz, A.N. Theofilopoulos, R.E. Stanford.
Circulating immune complexes in the idiophatic interstitial pneumonias.
N Eng J Med, 298 (1978), pp. 353
[43.]
F. Basset, M.J. Turiaf.
Identification par la microscopie dectronique de particules de nature probablement virales dans les lesions granulomateuses d’une histyocitose X pulmonaire.
CR Acad Sci (Paris), 261 (1965),
[44.]
J.R. Ruttner, M.A. Spycher, P.H.D. Sticher.
The detection of etiologics agents in interstitial pulmonary fibrosis.
Hum Path, 4 (1973), pp. 497
Copyright © 1982. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?