Goyal Rajiv, Gogia Pratibha, Chachra Vaibhav
Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India.
J Bronchology Interv Pulmonol. 2016 Jan;23(1):67-70. doi: 10.1097/LBR.0000000000000184.
Solitary pulmonary nodules pose a diagnostic challenge as traditional techniques like bronchoscopic transbronchial biopsies or percutaneous transthoracic needle biopsies suffer either from poor yield or unacceptable complications. The advent of endobronchial ultrasound (EBUS)-radial probe (RP) has helped to guide the operator to the lesion more accurately and thereby improve yield. Small biopsy forceps or cytology brushes can be passed through the guide sheath of the EBUS-RP, after removing the probe, to get specimens. However, a small specimen may sometimes prove inadequate for special molecular studies or genetic analysis. Recently, there have been feasibility reports of transbronchial cryobiopsies that can be safely performed with larger biopsy specimens. We report a case of solitary pulmonary nodules where EBUS-RP was used to guide a cryoprobe to get large transbronchial cryobiopsies successfully.
孤立性肺结节带来了诊断挑战,因为诸如支气管镜下经支气管活检或经皮经胸针吸活检等传统技术要么活检阳性率低,要么会出现难以接受的并发症。支气管内超声(EBUS)-径向探头(RP)的出现有助于更准确地引导操作者找到病变,从而提高活检阳性率。在移除探头后,小型活检钳或细胞学刷可通过EBUS-RP的引导鞘获取标本。然而,有时小标本可能不足以进行特殊分子研究或基因分析。最近,有关于经支气管冷冻活检的可行性报告,这种方法可以安全地获取更大的活检标本。我们报告一例孤立性肺结节病例,其中使用EBUS-RP引导冷冻探头成功获取了经支气管大冷冻活检标本。