Evaluating an integrated diagnostic work-up of virtual navigation bronchoscopy (VNB), confocal laser endomicroscopy and micro computerized tomography (micro-CT) in the diagnostic path of pulmonary lesions in the non-oncological patient.

The region(s) of interest that has/have to be sampled, will be selected upfront. Guided by the endobronchial pathway that is created by virtual bronchoscopy, the flexible bronchoscope will be navigated to the regions of interest and an optical biopsy of the region will be obtained using pCLE. One biopsy sample will be processed in the endoscopy suite to be able to prepare it for micro-CT analysis.

Inclusion Criteria:

• Presence of diffuse pulmonary disease necessitating bronchoscopic evaluation.
• Informed consent available
• Age > 18
• FVC > 50%pred
• DLCO > 35%pred
• PaO2 > 55 mmHg, pCO2 < 45 mmHg (ambient air)
• No exclusion criteria

Exclusion Criteria:

• Age > 75
• Systolic arterial pressure in the pulmonary artery : PAPS >40mmHg
• Platelet count <100000/µl
• INR > 1.4
• BMI >30
• Diffuse bullous lung disease
• Active anti-platelet or anticoagulant treatment
• Active heart failure or unstable coronary heart disease

Lung transplant recipients and diffuse interstitial lung disease without certain diagnosis