Lung Cryobiopsy in Hyderabad: Lung Biopsy for ILD Without Surgery
Transbronchial lung cryobiopsy (TBLC) is a way of taking lung tissue samples through a bronchoscope, using a probe that freezes and gently pulls away a small piece of lung. It’s mainly used to diagnose interstitial lung disease (ILD) and pulmonary fibrosis, giving larger samples than standard bronchoscopic biopsy without the chest incision of surgical lung biopsy. In Hyderabad, it’s performed by Dr. Kishan Srikanth Juvva at Apollo Hospitals, Financial District.
| Also called | Transbronchial lung cryobiopsy, TBLC, cryo lung biopsy |
| Main use | Diagnosing interstitial lung disease (ILD) when CT and blood tests can’t confirm the type |
| Where | Apollo Hospitals, Financial District |
| Anaesthesia | Deep sedation or general anaesthesia, with an airway tube |
| Procedure time | About 45–90 minutes |
| Hospital stay | Day-care or one night’s observation |
| Results | Pathology in days, then a multidisciplinary discussion |
| Cost | on request |
If you’ve been told you have “ILD”, “interstitial lung disease” or “lung fibrosis” on a CT scan, you’ll probably have heard the next question too: which type? There are more than 200 kinds of ILD. They behave differently and are treated differently.
Some can be identified from the CT scan, blood tests and history alone. When they can’t, a piece of lung tissue is needed. Cryobiopsy is one way of getting it without surgery.
What is a lung cryobiopsy?
During a bronchoscopy, a thin, flexible cryoprobe is passed into a small airway at the outer part of the lung, usually guided by X-ray (fluoroscopy). The probe tip is cooled to very low temperatures for a few seconds. The lung tissue around it freezes and sticks to it, and the probe and bronchoscope are withdrawn together, bringing a small piece of lung tissue with them.
Cryobiopsy samples are typically several times larger than those taken with standard biopsy forceps, and better preserved. That matters because ILD is diagnosed from the pattern of changes across the tissue. Tiny samples often can’t show it.
A small balloon is usually placed in the airway beforehand. It’s inflated straight after each sample, to control bleeding.
Who needs a lung cryobiopsy?
Cryobiopsy is considered when all of these apply:
- A CT shows ILD: a high-resolution CT (HRCT) scan shows ILD, but the pattern doesn’t confirm a specific diagnosis
- The rest of the work-up is inconclusive: blood tests for autoimmune disease, an exposure history (birds, moulds, dust, medicines) and lung function tests haven’t settled it
- A tissue diagnosis would change treatment: for example, between hypersensitivity pneumonitis, idiopathic pulmonary fibrosis and other fibrotic ILDs, which are treated quite differently
- The ILD team agrees: a pulmonologist, radiologist and pathologist (the multidisciplinary discussion, or MDD) agree a biopsy is the right next step
It isn’t needed when the CT pattern and clinical picture are already typical enough to diagnose without tissue. Many people with ILD never need a biopsy.
Who shouldn't have it
Cryobiopsy may not be safe if lung function is very poor (very low DLCO or FVC), if there’s significant pulmonary hypertension, a bleeding tendency, or blood thinners that can’t be paused, or if the person is too unwell for anaesthesia. These are checked beforehand with lung function tests, an echocardiogram and blood tests.
Ways to biopsy the lung for ILD: how cryobiopsy compares
| Method | How it’s done | Sample size | Typical use in ILD |
|---|---|---|---|
| Transbronchial forceps biopsy | Small forceps through a bronchoscope | Very small | Sarcoidosis, some infections; often too small for fibrotic ILD |
| Transbronchial lung cryobiopsy | Freezing probe through a bronchoscope | Larger, well preserved | Undiagnosed ILD when tissue is needed, in experienced centres |
| Surgical lung biopsy (VATS) | Keyhole chest surgery under general anaesthesia | Largest | When cryobiopsy is non-diagnostic or not suitable |
| CT-guided needle biopsy | Needle through the chest wall | Small core | Lumps and nodules; rarely used for ILD |
What the evidence says: the European Respiratory Society’s 2022 guideline suggests cryobiopsy as a replacement for surgical lung biopsy in patients with undiagnosed ILD, in centres experienced in the technique. If cryobiopsy doesn’t give an answer, it suggests stepping up to surgical biopsy. The same guideline found 30-day mortality of about 0.3% after cryobiopsy, compared with 2.3% after surgical lung biopsy, from separate pooled studies.
How accurate is cryobiopsy?
In a 2024 review of 70 studies covering more than 6,000 patients, published in the European Respiratory Review, cryobiopsy gave a diagnosis in about 81% of cases. The ERS guideline’s analysis found a somewhat lower yield than surgical biopsy (about 73% vs 91%), with surgery reserved for those whose cryobiopsy doesn’t settle the question.
Preparing for cryobiopsy
- Before booking:
- An HRCT scan (to plan which area to sample)
- Full lung function tests with DLCO
- Often an echocardiogram (to check lung blood pressure)
- Blood count and clotting tests
- Blood thinners: aspirin, clopidogrel, warfarin and newer blood thinners usually need stopping beforehand. Never stop them on your own.
- Fasting: about 6 hours, as for anaesthesia.
- Bring someone with you. No driving for 24 hours.
What happens during the procedure
- You’re given deep sedation or general anaesthesia, and a breathing tube or rigid bronchoscope is placed to secure the airway .
- A flexible bronchoscope is passed to the planned area. A blocking balloon is positioned to control bleeding.
- Under X-ray guidance, the cryoprobe is placed in the outer lung, frozen for a few seconds and withdrawn with the sample. This is usually repeated 2–4 times, often from more than one area.
- A chest X-ray or ultrasound is done afterwards, to check for an air leak.
The procedure usually takes 45–90 minutes in total.
Recovery
- Observation: you’re observed for several hours, and some people stay one night .
- Common: a cough, slight blood-streaked sputum and a sore throat for a day or two.
- Returning to normal: most people are back to normal activities in 2–3 days. Avoid heavy lifting and air travel for about a week .
Seek help urgently if you have:
- Sudden breathlessness
- Chest pain
- Coughing up more than a few teaspoons of blood
- A fever
Risks of lung cryobiopsy: the honest numbers
Cryobiopsy is a bigger procedure than a routine bronchoscopy. You deserve real numbers, not reassurance:
- Pneumothorax (air leak around the lung): about 5% in the 2024 review, and about 9% in the ERS guideline’s analysis. Some need a chest drain for a few days.
- Moderate to severe bleeding: about 12–14% across the two reviews. It’s usually controlled during the procedure with the balloon and other measures.
- Death within 30 days: about 0.3% in pooled studies, compared with about 2.3% for surgical lung biopsy.
- Other risks:
- Temporary low oxygen
- Infection
- A flare of the ILD (rare)
- Reactions to anaesthesia
Your risk depends on your lung function and overall health. That’s why the decision is made only after full testing and a discussion of the alternatives.
After the biopsy: results and the MDD
The pathologist examines the samples days later . ILD is then usually finalised at a multidisciplinary discussion (MDD), where the pulmonologist, radiologist and pathologist review the CT, clinical history and biopsy together. International ILD guidelines recommend this as the best way to reach an accurate ILD diagnosis.
You’ll then have a consultation to discuss the diagnosis and treatment. Treatment may include anti-fibrotic medicines, immune-suppressing treatment, removing an exposure, pulmonary rehabilitation and oxygen.
Lung cryobiopsy cost in Hyderabad
| Item | Approximate cost |
|---|---|
| Transbronchial lung cryobiopsy (including anaesthesia, fluoroscopy, cryoprobe) | on request |
| Histopathology | on request |
| Overnight stay, if needed | on request |
| Pre-procedure tests (PFT with DLCO, echo, bloods) | on request |
What changes the cost:
- Anaesthesia type
- Consumables: single-use cryoprobes and balloons
- Stay: a day-care stay or one night
- Extras: whether other samples (BAL, EBUS) are taken in the same session
Insurance: cryobiopsy is generally covered as an in-patient or day-care procedure under most health insurance policies, subject to terms. Apollo’s insurance desk confirms cashless approval beforehand.
Who performs cryobiopsy at Apollo Financial District?
Lung cryobiopsy is performed by Dr. Kishan Srikanth Juvva .
- Training:
- DM in Pulmonary and Critical Care Medicine
- Master’s in Interventional Pulmonology from the University of Florence, Italy
- Memberships:
- World Association for Bronchology and Interventional Pulmonology
- European Respiratory Society
- Indian Association for Bronchology
The ERS guideline recommends that cryobiopsy be done by trained operators in experienced centres.
Where to have a lung cryobiopsy in Hyderabad
| Apollo Hospitals, Financial District | Breathe Well Clinic, Kondapur | |
|---|---|---|
| Cryobiopsy procedure | Yes | No |
| ILD consultation, CT review, planning | Mon–Sat, 9 AM – 5 PM | Evenings (5:00–8:30 PM; Sunday, 10:00 AM–1:00 PM) |
| Results and follow-up | Yes | Yes |
| Book | +91 90598 73547 | +91 87122 23696 |
Lung cryobiopsy: frequently asked questions
What is a lung cryobiopsy?
A lung cryobiopsy is a biopsy taken through a bronchoscope, using a probe that freezes a small area of lung tissue so it can be removed. It gives larger, better-preserved samples than standard bronchoscopic biopsy, and is mainly used to diagnose interstitial lung disease without surgery.
Is a lung cryobiopsy a serious procedure?
It’s more involved than a routine bronchoscopy, with a risk of air leak (about 5–9%) and bleeding, which is usually controlled during the procedure. It avoids the chest incision of surgical lung biopsy, and has a lower reported 30-day mortality.
Is cryobiopsy the same as surgery?
No. Cryobiopsy is done through a bronchoscope passed down the windpipe, with no cut in the chest. It’s done under deep sedation or general anaesthesia. Surgical lung biopsy (VATS) is keyhole chest surgery, usually needing a chest drain and a few days in hospital.
How long does it take to recover from a lung cryobiopsy?
Most people go home the same day or after one night, and are back to normal activities within two to three days. A cough and slightly blood-streaked sputum for a day or two are common. Avoid heavy lifting and air travel for about a week, unless advised otherwise.
Does everyone with ILD need a biopsy?
No. Many people with ILD are diagnosed from the HRCT scan pattern, blood tests and their history, without a biopsy. A biopsy is considered only when the type of ILD remains unclear and knowing it would change treatment. An ILD multidisciplinary team usually makes this decision.
How accurate is lung cryobiopsy?
A 2024 review of 70 studies found lung cryobiopsy gave a diagnosis in about 81% of patients with ILD. Surgical biopsy is slightly more likely to give an answer, so it’s usually reserved for when cryobiopsy is non-diagnostic, or not suitable for the patient.
What happens if the cryobiopsy doesn't give a diagnosis?
The case is reviewed again by the ILD team. Depending on how the results fit with the CT and clinical picture, options include a working diagnosis with a treatment trial, or a surgical lung biopsy. The European Respiratory Society suggests surgical biopsy after a non-diagnostic cryobiopsy, when tissue is still needed.
How much does a lung cryobiopsy cost in Hyderabad?
At Apollo Hospitals, Financial District, a transbronchial lung cryobiopsy is priced on request, including anaesthesia and procedure charges, with pathology and pre-procedure tests extra . The total depends on the anaesthesia, consumables and the length of stay. It’s generally covered by health insurance as a hospital procedure.
Where can I get a lung cryobiopsy in Hyderabad?
Lung cryobiopsy is performed at Apollo Hospitals, Financial District, Nanakramguda, by pulmonologist Dr. Kishan Srikanth Juvva . ILD consultations and CT reviews are available at Apollo during the day, and in the evenings at Breathe Well Clinic, Kondapur. Call +91 90598 73547 to book.
Sources
- Korevaar DA, Colella S, Fally M, et al. European Respiratory Society guidelines on transbronchial lung cryobiopsy in the diagnosis of interstitial lung diseases, European Respiratory Journal, 2022 (TBLC as a replacement for surgical lung biopsy in experienced centres; step-up to SLB if non-diagnostic; pooled yield 72.9% vs 91.1%; pneumothorax 9.4%; moderate-severe bleeding 14.2%; 30-day mortality 0.3% vs 2.3%)
- A systematic review of procedural and sampling techniques for cryobiopsy in interstitial lung disease, European Respiratory Review, August 2024 (70 studies, 6,183 participants; yield ~81%; pneumothorax ~5%; moderate-severe bleeding ~12%)
- National Medical Commission advertising guidelines (6 Oct 2026), as summarised by HMS Consultants (factual fees permitted; no misleading claims)
Medically reviewed by Dr. Kishan Srikanth Juvva, MBBS, MD, DM (Pulmonary & Critical Care Medicine), Master’s in Interventional Pulmonology (University of Florence). Senior Consultant, Apollo Hospitals, Financial District. Reg. No.. This page is general information and doesn’t replace a consultation.