LAUSR

and SLB specimens) and the final diagnosis made at the second multidisciplinary assessment (MDA2) occurred in 17 of 21 cases. This is better than the concordance observed between both blinded SLB and MDA2 (13/21 cases) and TBLC and MDA2 (10/21 cases). Although the additional tissue that local pathologists would have had may be responsible for this difference, we wondered if access to clinical information may have been the major driver. Finally, if an MDA meeting is taken as the gold standard for ILD diagnosis, both blinded SLB and TBLC performed poorly, and the difference in concordance between pathology specimens and MDA2 (13/21 cases for SLB vs. 10/21 cases for TBLC) did not appear dramatic. Given the potential morbidity associated with either biopsy approach, many questioned whether lung biopsy of any kind truly leads to meaningful improvements in clinical outcomes in ILD (6, 7). In conclusion, we commend the authors for their well-done study, and acknowledge our ongoing confusion about the utility of lung histology for ILD diagnosis. Despite the poor concordance between TBLC and SLB, we hope cryobiopsy remains an area of study, as this paper has not completely “cooled off” our interest in this new and less invasive diagnostic technique. n