When should a patient with SSc-ILD undergo surgical lung biopsy?
A surgical lung biopsy may be indicated in patients with an atypical pattern of lung injury on CT scan or with compelling alternative explanations for ILD (e.g., concerns for hypersensitivity pneumonitis). Because it is well established that NSIP and UIP are the most common types of ILD encountered in SSc, and because histopathology has not been shown to impact prognosis in SSc-ILD, surgical lung biopsy is typically not indicated when HRCT is consistent with either pattern.
