Cryobiopsies

Cryobiopsies are a minimally invasive technique that uses extremely cold temperatures to retrieve tissue samples from living patients for histological analysis. The process employs a cryoprobe, which typically contains nitrous oxide or liquid nitrogen, to rapidly freeze the target tissue. Once frozen, the probe is retracted, bringing a piece of the affected organ or lesion with it. Cryobiopsies are most frequently applied in the evaluation of interstitial lung disease, central airway lesions, and certain gastrointestinal conditions, but can also be used in other organ systems where a rapid diagnostic sample is needed.

Compared with conventional forceps biopsies, cryobiopsies yield larger specimens with preserved architecture. This can improve diagnostic yield for diffuse lung disorders where tissue fragmentation limits interpretation. However, the procedure carries a higher risk of bleeding, especially in vascular lesions or when performed in the lung, and there is a potential for airway obstruction if a large tissue fragment is dislodged. Appropriate patient selection and meticulous procedural planning are essential to mitigate these risks. Contraindications include severe coagulopathy, uncontrolled bleeding disorders, or patients with compromised respiratory function that would impede safe retrieval and clearance of tissue fragments.

The history of cryobiopsy dates back to the 1950s in dermatology, but it has only recently been adopted in pulmonology and gastroenterology. Current guidelines recommend its use in specific clinical scenarios, such as suspected idiopathic pulmonary fibrosis, where a larger biopsy may be necessary to differentiate among histopathologic patterns. Ongoing research continues to refine the technique, improve safety protocols, and expand its applications across various medical specialties.