Division of Pneumology, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, Lausanne, 1011, Switzerland.
Department of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Lung. 2016 Dec;194(6):917-921. doi: 10.1007/s00408-016-9947-3. Epub 2016 Oct 4.
The role of radial-endobronchial ultrasound (R-EBUS) assisted transbronchial biopsy (TBB) for the diagnosis of peripheral pulmonary lesions is well established. However, no study has addressed its safety and value in hemato-oncological patients presenting with non-resolving infiltrates during persistent febrile neutropenia. To assess safety and feasibility of R-EBUS assisted TBB in severe thrombocytopenic and neutropenic patients. Over a period of 18 months, eight patients were assessed with R-EBUS assisted TBB after adequate platelet transfusion. This technique allowed precise localisation and sampling of the pulmonary lesions in seven of eight patients. In the seven patients, R-EBUS assisted TBB enabled treatment optimization. Invasive fungal infection was diagnosed in four patients, idiopathic acute fibrinous and organising pneumonia in three patients, and a granulomatous inflammation of undetermined origin in one patient. Importantly, no complications, such as bleeding, were observed. R-EBUS assisted TBB is a promising and safe procedure for the evaluation of nonresolving pulmonary infiltrates in febrile neutropenic hemato-oncological patients.
经支气管径向超声（R-EBUS）辅助经支气管活检（TBB）在诊断周围性肺部病变方面的作用已得到充分证实。然而，尚无研究针对在持续发热性中性粒细胞减少症期间出现未解决浸润的血液肿瘤患者探讨其安全性和价值。本研究旨在评估在严重血小板减少和中性粒细胞减少患者中，经支气管径向超声辅助经支气管活检的安全性和可行性。在 18 个月的时间里，在充分输注血小板后，对 8 例患者进行了经支气管径向超声辅助经支气管活检评估。该技术能够在 8 例患者中的 7 例中精确定位和取样肺部病变。在 7 例患者中，经支气管径向超声辅助经支气管活检能够优化治疗。4 例患者诊断为侵袭性真菌感染，3 例患者诊断为特发性急性纤维蛋白性和机化性肺炎，1 例患者诊断为原因不明的肉芽肿性炎症。重要的是，未观察到任何并发症，如出血。经支气管径向超声辅助经支气管活检是一种有前途且安全的方法，可用于评估发热性中性粒细胞减少的血液肿瘤患者中未解决的肺部浸润。
