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Tanaka Y, Kido T, Sakamoto N, Hara A, Kato T, Miyashita R, Ozasa M, Tokito T, Okuno D, Takeda K, Yura H, Takemoto S, Takazono T, Ishimoto H, Obase Y, Ishimatsu Y, Miyazaki Y, Mukae H. Lung Involvement in Adult T-Cell Lymphoma Diagnosed Using Bronchoscopic Cryobiopsy: A Case Report and Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2015. [PMID: 38004063 PMCID: PMC10673562 DOI: 10.3390/medicina59112015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
The diagnosis of pulmonary lymphoma using small tissue samples is difficult and often requires surgical procedures; thus, a less invasive sampling method is desirable. Moreover, pulmonary involvement in adult T-cell lymphoma (ATL) is often difficult to diagnose, especially in cases without characteristic flower cells. Here, we present the case of a 78-year-old man, in whom pathological examination of the transbronchial lung biopsy (TBLB) specimen did not reveal malignant findings; therefore, transbronchial lung cryobiopsy (TBLC) in combination with endobronchial ultrasonography (EBUS) was used to diagnose ATL based on the pathological findings. A literature review identified 18 cases of pulmonary lymphomas diagnosed using TBLC. Among the 19 cases, including our own, 16 cases were of B-cell lymphoma (84.2%), and the present case is the first case of ATL diagnosed using TBLC. Eighty percent of the cases underwent a biopsy (more than two samples) of the middle or lower lobe and were diagnosed without major complications. EBUS was used with TBLC in three cases to identify the location of the pulmonary lesions. In the present case, EBUS was also useful for avoiding vascular biopsy. Although large-scale prospective studies are required to establish precise guidelines for diagnosing pulmonary lymphomas using TBLC, our case report and review contributes to a deeper understanding of the diagnosis of rare diseases.
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Affiliation(s)
- Yasuhiro Tanaka
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Atsuko Hara
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takeharu Kato
- Department of Hematology, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (T.K.)
| | - Ritsuko Miyashita
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takatomo Tokito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Daisuke Okuno
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Hirokazu Yura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8102, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8102, Japan;
| | - Yasushi Miyazaki
- Department of Hematology, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (T.K.)
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan; (Y.T.); (N.S.); (A.H.); (R.M.); (M.O.); (T.T.); (D.O.); (K.T.); (H.Y.); (S.T.); (T.T.); (H.I.); (Y.O.); (H.M.)
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Zhu D, Shen Y, Huang J, Zhao L. Intravascular large B-cell lymphoma with diffuse ground glass lesion on chest computed tomography diagnosed using transbronchial lung cryobiopsy: a case report. Transl Cancer Res 2022; 10:4571-4576. [PMID: 35116313 PMCID: PMC8798442 DOI: 10.21037/tcr-21-769] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/16/2021] [Indexed: 12/15/2022]
Abstract
A 68-year-old man was presented with high fever of unknown origin for 3 weeks and non-productive cough for 1 week. A chest computed tomography (CT) scan revealed multiple nodules and ground glass opacities (GGO) in both lungs. The patient was initially diagnosed with hypersensitivity pneumonitis based on the result of bronchoalveolar lavage fluids (BALF). After treatment with methylprednisolone for 2 weeks, the patient’s fever recurred, with no resolution of lesions on chest CT. The patient consented to positron emission tomography (PET)/CT. It showed that fluorodeoxyglucose (FDG) metabolism was significantly increased in the spleen, whole skeleton, and both lungs, suggesting a malignant hematological disease. Large B-cell lymphoma was diagnosed by bone marrow puncture and flow cytometry. Transbronchial lung cryobiopsy was performed to evaluate the diffuse lung lesion. Hematoxylin-eosin (HE) staining showed diffuse infiltration of heterotypic cells in the pulmonary interstitial capillaries. Furthermore, immunohistochemical examination results suggested lung infiltration of B lymphohematopoietic system tumors. The patient was finally diagnosed as intravascular large B-cell lymphoma (IVLBCL). IVLBCL with diffuse lung ground glass lesions is very rare and difficult to diagnose. Transbronchial lung cryobiopsy, as an emerging procedure, plays an important role in the diagnosis of interstitial lung disease and has gained popularity for a lower complication rate and acquisition of more tissue samples.
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Affiliation(s)
- Dongyi Zhu
- Department of Respiratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan Shen
- Department of Emergency Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jianhao Huang
- Department of Respiratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Liming Zhao
- Department of Respiratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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Hoshi M, Kobayashi N, Tanaka K, Somekawa K, Kaneko A, Izawa A, Seki K, Tagami Y, Aoki A, Fujii H, Watanabe K, Horita N, Hara Y, Matsumura M, Enaka M, Hagihara M, Kaneko T. Diagnostic utility of transbronchial biopsy for Hodgkin's lymphoma: A case study. Thorac Cancer 2021; 12:3281-3285. [PMID: 34698453 PMCID: PMC8636206 DOI: 10.1111/1759-7714.14190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022] Open
Abstract
Lung lesions of Hodgkin's lymphoma (HL) are rare and difficult to diagnose by nonsurgical biopsy. We herein present the case of a 72-year-old Japanese male who presented with accumulation of lung infiltrates and masses bilaterally on the lungs for 3 years. Although transbronchial lung biopsy (TBB) and computed tomography-guided biopsy were conducted several times, his diagnosis remained inconclusive. On further deterioration of lung lesions, the patient was transferred to our hospital. Positron emission tomography revealed increased accumulation in the bilateral lungs and right supraclavicular lymph nodes. Surgical biopsy of the lymph node was performed. He was finally diagnosed with HL and underwent chemotherapy with doxorubicin, vinblastine, dacarbazine, and brentuximab vedotin. After chemotherapy, the lung lesion showed significant regression. A literature review indicated that the diagnostic success rate of TBB was low (18.5%) in cases of lung lesions in HL.
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Affiliation(s)
- Miki Hoshi
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Nobuaki Kobayashi
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Katsushi Tanaka
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kohei Somekawa
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Ayami Kaneko
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Ami Izawa
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kenichi Seki
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Yoichi Tagami
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Ayako Aoki
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Hiroaki Fujii
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Keisuke Watanabe
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Nobuyuki Horita
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Yu Hara
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Mai Matsumura
- Department of PathologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Makiko Enaka
- Department of Molecular PathologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Maki Hagihara
- Department of Hematology and Clinical ImmunologyYokohama City University Graduate School of MedicineYokohamaJapan
| | - Takeshi Kaneko
- Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan
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Liao TY, Lin CC, Yuan CT, Lin CK, Ho CC. Mucosa-associated lymphoid tissue lymphoma with isolated endobronchial involvement. Respirol Case Rep 2020; 8:e00672. [PMID: 33088571 PMCID: PMC7565112 DOI: 10.1002/rcr2.672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/17/2020] [Indexed: 11/21/2022] Open
Abstract
Primary pulmonary lymphoma is an uncommon disease, and extranodal marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT) is the most common type of pulmonary lymphoma. The most frequent pattern observed in chest computed tomography (CT) is consolidation, followed by nodules and mass. The differentiation of pulmonary MALT lymphoma from other lung diseases is critical for disease management and treatment. However, pulmonary MALT lymphoma with isolated endobronchial manifestation has seldomly been reported. Here, we report a case of an elderly woman who presented with a four‐month history of cough, dyspnoea, and haemoptysis. Chest CT scan revealed left main bronchus narrowing without lung parenchymal lesion. Bronchoscopic examination was performed, and the diagnosis of primary pulmonary MALT lymphoma with isolated endobronchial involvement was made. She has been successfully treated with rituximab.
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Affiliation(s)
- Ting-Yu Liao
- Division of Pulmonary Medicine, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
| | - Chien-Chin Lin
- Division of Hematology, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan.,Department of Laboratory Medicine National Taiwan University Hospital Taipei Taiwan
| | - Chang-Tsu Yuan
- Graduate Institute of Clinical Medicine National Taiwan University Taipei Taiwan.,Department of Pathology National Taiwan University Hospital Taipei Taiwan.,Department of Pathology National Taiwan University Cancer Center Taipei Taiwan
| | - Ching-Kai Lin
- Division of Pulmonary Medicine, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan.,Department of Medicine National Taiwan University Cancer Center Taipei Taiwan
| | - Chao-Chi Ho
- Division of Pulmonary Medicine, Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
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Bianchi R, Dubini A, Asioli S, Ravaglia C, Tomassetti S, Puglisi S, Piciucchi S, Gurioli C, Gurioli C, Fiocca R, Poletti V. Transbronchial cryobiopsy: an effective tool in the diagnosis of lymphoproliferative disorders of the lung. ERJ Open Res 2020; 6:00260-2019. [PMID: 32743007 PMCID: PMC7383053 DOI: 10.1183/23120541.00260-2019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 05/18/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction Malignant lymphoproliferative disorders are rarely observed in the lung and, considering their clinical and radiological heterogeneity, diagnosis is often difficult and may require invasive methods. Transbronchial cryobiopsy has been confirmed as a new tool in the diagnosis of interstitial lung diseases, given its fewer risks and costs compared to surgical approach. This study is aimed at assessing the effectiveness of cryobiopsy in the diagnosis of lymphoproliferative disorders. Materials and methods Among 970 consecutive cryobiopsies, performed between January 2011 and June 2018 at Morgagni Hospital of Forlì, Italy, 13 cases of lymphoproliferative disorders were collected. Results In 12 out of 13 cases a precise pathological diagnosis could be reached with the support of immunohistochemistry (IHC) and molecular ancillary studies. In the only case in which cryobiopsy did not lead to a definitive diagnosis, the subsequent surgical biopsy also did not help to clarify the diagnosis. Severe bleeding or pneumothorax did not occur in any case. On average, five biopsies were obtained per case, with a mean total area of 1161 mm2, and only 5 out of 65 specimens were inadequate for diagnosis. Instant freezing did not produce tissue artefacts nor did it affect IHC and molecular tests. In all cases the amount of available tissue was sufficient for all ancillary studies. Conclusions Transbronchial lung cryobiopsy is safe and effective for diagnosis in patients with suspected pulmonary involvement by lymphoproliferative disorders and it should therefore be considered a valid alternative to surgical biopsy in such cases. Cryobiopsy is an effective method in the diagnosis of lymphoproliferative disorders. Transbronchial cryobiopsy allows immunohistochemical and molecular analysis. No severe bleeding or pneumothorax were observed in this study.https://bit.ly/2zdHPTn
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Affiliation(s)
- Rita Bianchi
- Dept of Pathology, Università di Genova, Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Silvia Asioli
- Dept of Pathology, Ospedale GB Morgagni, Forlì, Italy
| | - Claudia Ravaglia
- Dept of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy
| | - Sara Tomassetti
- Dept of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy
| | - Silvia Puglisi
- Dept of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy
| | | | | | - Carlo Gurioli
- Dept of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy
| | - Roberto Fiocca
- Dept of Pathology, Università di Genova, Ospedale Policlinico San Martino, Genoa, Italy
| | - Venerino Poletti
- Dept of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy.,Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
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Lin CK, Jan IS, Yu KL, Chang LY, Fan HJ, Wen YF, Ho CC. Rapid on-site cytologic evaluation by pulmonologist improved diagnostic accuracy of endobronchial ultrasound-guided transbronchial biopsy. J Formos Med Assoc 2020; 119:1684-1692. [PMID: 31964550 DOI: 10.1016/j.jfma.2020.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/01/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND/PURPOSE Rapid on-site cytologic evaluation (ROSE) has been shown to improve the diagnostic accuracy of endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB). However, ROSE by a cytopathologist or cytotechnologist is not always available during the procedure. The purposes of this study were to verify that a pulmonologist, after receiving training in cytology, could accurately assess an EBUS-TBB specimen on-site, and to evaluate the contribution of ROSE to EBUS-TBB. METHODS A retrospective chart review of patients who underwent EBUS-TBB for diagnosis of peripheral pulmonary lesions (PPLs) from January 2014 to June 2017 was performed. PPLs without a malignant diagnosis were excluded. The ROSE result determined by a pulmonologist was compared to the formal imprint cytologic report and pathologic report. The diagnostic accuracy of EBUS-TBB was also compared between those with and without ROSE. RESULTS Two hundred ninety-three patients who underwent 336 EBUS-TBB procedures for PPL diagnosis and were found to have proven malignancy were enrolled. Eighty-six procedures were performed with ROSE. With the formal imprint cytologic diagnosis as the standard, ROSE had 96.9% sensitivity, 68.2% specificity, 89.9% positive predictive value (PPV), 88.2% negative predictive value (NPV), and 89.5% diagnostic accuracy. With the formal pathologic result as the standard, ROSE had 88.2% sensitivity, 80% specificity, 97.1% PPV, 47.1% NPV, and 87.2% diagnostic accuracy, respectively. The diagnostic accuracy was significantly higher when ROSE was performed during EBUS-TBB (88.4% vs 68.0%, P < 0.001). CONCLUSION A trained pulmonologist can interpret adequately cytologic smears on-site and effectively improve the accuracy of EBUS-TBB in the diagnosis of PPLs.
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Affiliation(s)
- Ching-Kai Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - I-Shiow Jan
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kai-Lun Yu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan
| | - Lih-Yu Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan
| | - Hung-Jen Fan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Chu-Tung Branch, Hsinchu County, Taiwan
| | - Yueh-Feng Wen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan
| | - Chao-Chi Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Gupta A, Youness H, Dhillon SS, Harris K. The value of using radial endobronchial ultrasound to guide transbronchial lung cryobiopsy. J Thorac Dis 2019; 11:329-334. [PMID: 30863611 DOI: 10.21037/jtd.2018.10.116] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Conventional transbronchial biopsies have a low diagnostic yield for interstitial lung disease (ILD) and peripheral lung nodules due to crush artifact and smaller tissue samples. Transbronchial lung cryobiopsies (TBLC) circumvent these drawbacks but are associated with higher incidence of complications including life threatening airway bleeding and pneumothoraces. Radial probe endobronchial ultrasound (RP-EBUS) can be used during the TBLC for assessing the biopsy site prior to the cryobiopsy to avoid vasculature and to decrease the risk of complications. There is no standardized protocol for this technique and the available literature mostly consists of single center case reports/series. The aim of this review is to investigate the existing literature for RP-EBUS assisted TBLC for diagnosing both ILD and peripheral lung nodules. We will describe the techniques used and compare the diagnostic yield and complication rates with other modalities.
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Affiliation(s)
- Ankit Gupta
- Division of Pulmonary and Critical Care Medicine, Hartford Healthcare, Norwich, CT, USA
| | - Houssein Youness
- Section of Pulmonary, Critical Care and Sleep Medicine, Interventional Pulmonary Program, Oklahoma City VA Health Care System and University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Samjot Singh Dhillon
- Division of Pulmonary and Critical Care Medicine, Interventional Pulmonary, The Permanente Medical Group, Kaiser Permanente Roseville and Sacramento Medical Center, Roseville, CA, USA
| | - Kassem Harris
- Department of Medicine, Interventional Pulmonology Section, New York Medical College, Westchester Medical Center, Valhalla, NY, USA
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