Interstitial lung disease in the immunocompetent
patient is often a difficult challenge for the clinician,
especially when no diagnostic clues are present after a
thorough clinical assessment, laboratory examination
including serology for specific connective tissue disease,
chest radiography, and high-resolution computed
tomography (HRCT). Bronchoalveolar lavage and
transbronchial biopsy are usually the next step [1].
Thoracoscopy has been safely and successfully
performed by well-trained pulmonologists for several
decades [2]. The introduction of modern video
equipment and more refined instrumentation has
expanded the indications [3]. Medical thoracoscopic
lung biopsy (MTLB) in the diagnosis of interstitial
lung disease can be considered a second choice after
failure of bronchoalveolar lavage (BAL) and trans
bronchial lung biopsy (TBLB) to provide the
diagnosis, and this technique has some advantages
over surgical lung biopsy (SLB). The possibility to
take several biopsies under visual guidance and lower
morbidity are the most important advantages [4].