{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T09:39:06Z","timestamp":1768556346105,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T00:00:00Z","timestamp":1616457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The inflammation and fibrosis in diffuse parenchymal lung diseases (DPLDs) in varied proportions give rise to different patterns in radiology and histopathology. The radiological pattern on CT of the thorax most often allows us to make a diagnosis with varying levels of confidence, to optimize management. With a multidisciplinary team bringing the strengths of their individual domains of knowledge, clinical, radiological, histopathological, and in many cases rheumatological, the level of confidence in making this diagnosis increases, often to the stage where the diagnosis is most often right, is concordant with the diagnosis achieved at histopathology and therefore obviates the need for lung biopsy which carries its own costs and risks of complications. Our study emphasizes the role of the multidisciplinary team (MDT) in the management of DPLDs at a tertiary care referral center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Every case of DPLD presenting to our pulmonology department was discussed in an MDT meeting before subjecting them to any diagnostic intervention or therapy. A clinico\u2010radiological diagnosis was made according to the 2002 ATS\/ERS guidelines initially. Later an official ATS\/ERS\/JRS\/ALAT statement on idiopathic pulmonary fibrosis and a 2013 ATS\/ERS consensus for the classification and diagnosis of idiopathic interstitial pneumonia was used. The concordance in our study was defined as the percentage of histopathological diagnoses that were identical to the clinico\u2010radiological MDT diagnosis prior to the biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 434 patients with DPLDs were evaluated. The MDT suggested biopsy for only 38.7% (168\/434) patients since the pattern was very clear in 266 (61.3%) cases. As not all patients consented to undergo the biopsy procedure when recommended, histopathology was obtained in 102 patients. The histological diagnosis was concordant with the initial MDT diagnosis in 80.3% (82\/102) of samples. On an individual basis, connective tissue disease\u2010interstitial lung disease and sarcoidosis showed the best concordance (87%). In idiopathic non\u2010specific interstitial pneumonitis (NSIP) cases, the histopathological diagnosis concurred in only 53.3% (8\/15), out of which 8 were NSIP, 4 were usual interstitial pneumonia, and 3 were reported as inadequate sampling on histopathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The MDT plays a crucial role in the diagnosis of DPLDs. Not every pattern requires biopsy confirmation. However, an idiopathic non\u2010specific interstitial pneumonitis diagnosis by the MDT should probably be better confirmed by biopsy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13358","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T17:08:10Z","timestamp":1615828090000},"page":"761-769","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Multidisciplinary team obviates biopsy in most patients with diffuse parenchymal lung diseases\u2014A retrospective study from India"],"prefix":"10.1111","volume":"15","author":[{"given":"Bangalore Venkataraman","family":"Murali Mohan","sequence":"first","affiliation":[{"name":"Department of Pulmonology and Internal Medicine Mazumdar Shaw Medical Center Narayana Health City  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-5008","authenticated-orcid":false,"given":"Syed Zulkharnain","family":"Tousheed","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Internal Medicine Mazumdar Shaw Medical Center Narayana Health City  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poojaramuddanahally Hanumantharayappa","family":"Manjunath","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Internal Medicine Mazumdar Shaw Medical Center Narayana Health City  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malapaka Ramakrishna","family":"Ravichandra","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Internal Medicine Mazumdar Shaw Medical Center Narayana Health City  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramanjaneya","family":"Ranganatha","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Internal Medicine Mazumdar Shaw Medical Center Narayana Health City  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vellaichamy M.","family":"Annapandian","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Narayana Hrudayalaya Foundations  Bengaluru India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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