Na Wang, Zhibing Luo, Shuangshuang Deng, Qiang Li
BACKGROUND: Blastomycosis is a fungal infectious disease prevalent in North America and rarely reported in Asia. Misdiagnosis of malignancy and other infectious diseases were reported. CASE PRESENTATION: A 24-years-old male patient presented with chronic non-productive cough of 4 months duration. He had been diagnosed with Mycobacterium tuberculosis infection and lung malignancy elsewhere and presented to us as the symptoms persisted. We offered him the biopsy under endobronchial ultrasound-guide sheath-transbronchial lung biopsy and sample specimen were sent for next generation sequencing analysis, returned as Blastomyces Dermatitidis infection...
July 11, 2020: BMC Pulmonary Medicine
Roel L J Verhoeven, Jurgen J Fütterer, Wouter Hoefsloot, Erik H F M van der Heijden
BACKGROUND: Bronchoscopic diagnosis of small peripheral lung lesions suspected of lung cancer remains a challenge. A successful endobronchial diagnosis comprises navigation, confirmation, and tissue acquisition. In all steps, 3-dimensional information is essential. Cone-beam computed tomography (CBCT) imaging can provide computed tomography information and 3-dimensional augmented fluoroscopy imaging. We assessed whether CBCT imaging can improve navigation and diagnosis of peripheral lesions by 2 clinical workflows with a cross-over design: (1) a primary CBCT and radial endobronchial ultrasound mini probe imaging-based approach and (2) a primary electromagnetic navigation (EMN) and radial endobronchial ultrasound mini probe imaging-based approach...
July 8, 2020: Journal of Bronchology & Interventional Pulmonology
David N Poller, Fernando Schmitt
In diagnostic cytology, the known site-specific false positive rates at various anatomical sites for the risk malignancy (ROM) when a confirmed malignant diagnosis is made are comparatively well documented. ROM figures for diagnostic cytology specimens may vary according to the anatomical site of the specimen, the exact nature of the specimen received, the staining method(s) used, and the use of additional laboratory techniques including molecular profiling; furthermore, they often differ to some extent from institution to institution, between differing cytologists within the same institution, and over time...
July 10, 2020: Cancer Cytopathology
Prajowl Shrestha, Karan Madan, Vijay Hadda, Ashish Upadhyay, Saurabh Mittal, Pawan Tiwari, R M Pandey, Rakesh Garg, G C Khilnani, Randeep Guleria, Anant Mohan
Background: Central airway obstruction (CAO) is a potentially lethal condition that requires urgent endobronchial intervention and may occur due to several nonmalignant causes. The effect of these interventions on clinically relevant outcomes such as symptomatic and functional status over a period of time is, however, sparsely studied. Materials and Methods: Consecutive patients with CAO due to nonmalignant causes and undergoing various therapeutic bronchoscopy procedures were evaluated...
July 2020: Lung India: Official Organ of Indian Chest Society
Waqas Aslam, Hans J Lee, Carla R Lamb
Interventional pulmonology (IP) is a maturing subspecialty of pulmonary medicine. The robust innovation in technology demands standardization in IP training with both disease and technology driven training. Simulation based training should be considered a part of IP training as seen in other procedural and surgical subspecialties. Procedure volume is a component of training; however, this does not guarantee or translate into competency for learners. Basic competency skills can be assessed using standardized well validated assessment tools designed for various IP procedures including flexible bronchoscopy, endobronchial ultrasound guided transbronchial needle aspiration (EBUS TBNA), rigid bronchoscopy and chest tube placement; however, further work is needed to validate tools in all procedures as new technologies are introduced beyond fellowship training...
June 2020: Journal of Thoracic Disease
Roberto F Casal, Audra J Schwalk, Natalie Fowlkes, Rebeca Romero Aburto, William Norton, Katherine A Dixon, Steven Lin, Simona F Shaitelman, Gouthami Chintalapani, Lori Hill
Background: Loco-regionally advanced lung cancer is typically treated with a combination of chemotherapy and radiation therapy, but overall survival and local control remain poor. Radio-enhancing nanoparticles such as NBTXR3 activated by radiotherapy results in increased cell death and potentially an anti-tumor immune response. The goal of this study was to assess the feasibility and safety of endobronchial ultrasound (EBUS)-guided injection of NBTXR3 into mediastinal and hilar lymph nodes (LN), as well as assess nanoparticle retention in the LN post-injection...
May 2020: Journal of Thoracic Disease
Abhishek Biswas, Michael A Jantz, Sebastian Fernandez-Bussy, Mindy Flanagan, Hiren J Mehta
Background: Endobronchial stents that are used to treat airway obstruction may migrate over time. These stents can be repositioned. However, not much has been reported about this technique. We retrospectively reviewed our experience with self-expanding metallic stents (SEMS) and attempted to determine-(I) factors related to successful stent repositioning; (II) determine its impact on survival. Methods: Demographic, medical history, and stent-related procedure factors were extracted from the electronic health record...
May 2020: Journal of Thoracic Disease
Ji Soo Choi, Eun Hye Lee, Sang Hoon Lee, Ah Young Leem, Kyung Soo Chung, Song Yee Kim, Ji Ye Jung, Young Ae Kang, Moo Suk Park, Joon Chang, Young Sam Kim
Background: Flexible bronchoscopy is one of the most essential procedures for diagnosis and treatment of pulmonary disease. This study aimed to identify the risk factors associated with the occurrence of hypoxia in adults undergoing flexible bronchoscopy under sedation. Methods: We retrospectively analyzed 2,520 patients who underwent flexible bronchoscopy under sedation at our tertiary care university hospital in South Korea between January 1, 2013 and December 31, 2014...
July 9, 2020: Tuberculosis and Respiratory Diseases
Saumil Datar, Henriette De La Garza, Aditya Srinivasan, Gloria Iliescu, Neda Kalhor, Horiana Grosu
Thymomas are slow-growing neoplasia arising from the epithelial cells of the thymus that usually present with respiratory symptoms, superior vena cava syndrome, or parathymic syndromes. Approximately 30% of thymomas develop myasthenia gravis. An additional 5% of patients with thymomas have other systemic syndromes, including rheumatoid arthritis, thyroiditis, red cell aplasia, systemic lupus erythematosus, and Cushing syndrome. Rarely, patients can present with diarrhea due to thymoma-associated autoimmune gastrointestinal pathologies that include Good syndrome (acquired hypogammaglobulinemia), thymoma- associated multiorgan autoimmunity, and autoimmune enteropathy...
2020: Case Reports in Pulmonology
Edoardo Mercadante, Gabriele Alessandrini, Daniele Forcella, Enrico Melis, Filippo Gallina, Francesco Facciolo
Isolated endobronchial tumors of the left main bronchus are quite rare. They are treated by surgical resection, preferably using lung-sparing techniques, when possible. These procedures are technically challenging and are usually performed through a standard thoracotomy.  This video tutorial shows a left main bronchus sleeve resection with distal lobar carina reconstruction, performed through a uniportal thoracoscopic approach, for a typical carcinoid tumor of the distal left main bronchus.
July 6, 2020: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Pietro Bertini, Alessandro Ribechini, Fabio Guarracino
BACKGROUND: Pulmonary embolism (PE) is a life-threatening disease difficult to diagnose and manage in severe hemodynamic unstable patients. Transoesophageal echocardiography (TEE) is considered useful to improve diagnosis, but such approach has physical limitations for the interposition of the airways preventing the clear assessment of the left pulmonary artery. Endobronchial ultrasound (EBUS), a recently developed technique carried out using a modified bronchoscope having a small ultrasound convex probe at the tip allowing to perform ultrasonography examination of the mediastinum, can extensively visualize the pulmonary arteries on both sides...
July 6, 2020: Cardiovascular Ultrasound
Yu-Chen Liao, Wei-Ciao Wu, Ming-Hui Hsieh, Chuen-Chau Chang, Hsiao-Chien Tsai
INTRODUCTION: Evolving techniques in the field of therapeutic bronchoscopy have led to the return of rigid bronchoscopy in the treatment of complex central airway disease. Rigid bronchoscopy is typically performed under general anesthesia because of the strong stimulation caused by metal instruments. Anesthesia for rigid bronchoscopy is challenging to administer because anesthesiologists and interventionists share the same working channel: the airway. Previously reviewed anesthetic methods are used primarily for short procedures...
July 2, 2020: Medicine (Baltimore)
Susan M Dabu-Bondoc
PURPOSE OF REVIEW: This article provides an overview of standard procedures currently performed in nonoperating room anesthesia (NORA) and highlights anesthetic implications. RECENT FINDINGS: Novel noninvasive interventional procedures remain on the rise, accelerating demand for anesthesia support outside the conventional operating room. The field of interventional oncology has introduced a variety of effective minimally invasive therapies making interventional radiology gain a major role in the management of cancer...
August 2020: Current Opinion in Anaesthesiology
M Mondoni, R F Rinaldo, P Carlucci, S Terraneo, L Saderi, S Centanni, G Sotgiu
Flexible bronchoscopy is a key diagnostic and therapeutic tool. New endoscopes and technologically advanced navigational modalities have been recently introduced on the market and in clinical practice, mainly for the diagnosis of mediastinal lymph adenopathies and peripheral lung nodules. Bronchoscopic sampling tools have not changed significantly in the last three decades, with the sole exception of cryobiopsy. We carried out a non-systematic, narrative literature review aimed at summarizing the scientific evidence on the main indications/contraindications, diagnostic yield, and safety of the available bronchoscopic sampling techniques...
July 2, 2020: Pulmonology
William R Kennedy, Pamela P Samson, Prashant Gabani, John Nikitas, Jeffrey D Bradley, Michael C Roach, Clifford G Robinson
PURPOSE/OBJECTIVES: Before definitive stereotactic body radiation therapy (SBRT) for presumably node-negative, early-stage NSCLC, many patients are staged with PET/CT alone. In patients undergoing PET/CT prior to SBRT, the role of invasive nodal staging (INS) with endobronchial ultrasound (EBUS) or mediastinoscopy is uncertain. We sought to characterize the impact of nodal staging modality on outcomes. MATERIALS/METHODS: Patients receiving definitive SBRT for T1-2N0 NSCLC deemed node-negative by either PET/CT plus INS (EBUS or mediastinoscopy) or PET/CT alone were identified...
July 2, 2020: Radiotherapy and Oncology
Tomoyuki Nakano, Hiroyoshi Tsubochi, Kentaro Minegishi, Shunsuke Endo
BACKGROUND: Secondary pneumothorax after chemotherapy for a malignant pulmonary tumor is a complication from a large cavity causing refractory pneumothorax. CASE PRESENTATION: A 61-year-old man was referred due to prolonged air leakage from a pulmonary cavity that developed after treatment for pulmonary metastases from renal cell carcinoma. As air leakage continued after thoracic drainage and endobronchial occlusion, we planned thoracoscopy-assisted surgery. Intraoperatively, a large cavity opening to the pulmonary cavity was found in the left upper lobe...
July 1, 2020: Surgical Case Reports
Minoru Inomata, Naoyuki Kuse, Nobuyasu Awano, Mari Tone, Hanako Yoshimura, Tatsunori Jo, Jonsu Minami, Kohei Takada, Bae Yuan, Toshio Kumasaka, Hideaki Yamakawa, Shintaro Sato, Kazunori Tobino, Hidekazu Matsushima, Tamiko Takemura, Takehiro Izumo
Transbronchial lung cryobiopsy (TBLC) has been increasingly utilised to diagnose diffuse parenchymal lung diseases (DPLDs) and lung cancers; however, TBLC protocols have not yet been standardised and the rate of complications associated with this procedure vary widely. Therefore, this prospective multicentre observational study investigated the safety and utility of the TBLC technique in patients with diffuse and localised respiratory diseases. This study was conducted at multiple medical centres in Japan between July 2018 and April 2019...
April 2020: ERJ Open Research
Karin Klooster, T David Koster, Christoph Ruwwe-Glösenkamp, Dorothea Theilig, Felix Doellinger, Jacopo Saccomanno, Huib A M Kerstjens, Dirk-Jan Slebos, Ralf-Harto Hübner
Purpose: Lung volume reduction using one-way endobronchial valves is a bronchoscopic treatment for patients with severe emphysema without collateral ventilation between the treatment target lobe and the ipsilateral lobe(s). CT-scan fissure analysis is often used as a surrogate to predict the absence of collateral ventilation. We aimed to evaluate the predictive value of the fissure completeness score (FCS) compared to the functional Chartis measurement of collateral ventilation and to provide cut-off values of the FCS in patient selection...
2020: International Journal of Chronic Obstructive Pulmonary Disease
Inderpaul Singh Sehgal, Nalini Gupta, Sahajal Dhooria, Ashutosh Nath Aggarwal, Karan Madan, Deepali Jain, Parikshaa Gupta, Neha Kawatra Madan, Arvind Rajwanshi, Ritesh Agarwal
Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is presently the preferred modality for sampling mediastinal lymph nodes. There is an unmet need for standardization of processing and reporting of cytology specimens obtained by EBUS-TBNA. The manuscript is a state-of-the-art review on the technical aspects of processing and reporting of EBUS-TBNA specimens. A literature search was conducted using the PubMed database, and the available evidence was discussed among the authors. The evidence suggests that at least one air-dried and one alcohol-fixed slide should be prepared from each lymph node pass...
April 2020: Journal of Cytology
Osama Mosalem, Fawzi Abu Rous, Calvin Abro, Shouq Kherallah
No abstract text is available yet for this article.
June 30, 2020: BMJ Case Reports
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