Ulaş Ali Bilal, Eroğlu Atilla, Aydın Yener, Araz Ömer, Ahmed Ayman
Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey.
Department of Chest Diseases, Atatürk University Faculty of Medicine, Erzurum, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jun 25;27(3):350-354. doi: 10.5606/tgkdc.dergisi.2019.17479. eCollection 2019 Jul.
This study aims to evaluate the diagnostic yield of fiberoptic bronchoscopy in ruptured pulmonary hydatid cysts indistinguishable from pulmonary masses on imaging techniques.
Between January 2000 and January 2018, a total of 45 consecutive patients (27 males, 18 females; mean age 46.4±13.5 years; range, 23 to 78 years) who underwent fiberoptic bronchoscopy to establish the definitive diagnosis following radio-diagnostic procedures were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, preoperative diagnostic studies, bronchoscopic findings, and postoperative diagnosis were recorded.
Endobronchial hyperemia (n=42) and purulent secretion (n=34) are the most common findings of bronchoscopy. The most specific finding was the presence of pieces of cystic membranes in 23 patients. Scolices were seen in five patients in bronchial aspirate. In one patient, both pieces of cystic membranes and scolices in bronchial aspirate were detected. The preliminary diagnosis of a hydatid cyst was made based on these findings in 28 patients (62.2%) preoperatively. The definitive diagnosis of a hydatid cyst was confirmed through thoracotomy in all patients.
Bronchoscopy is a particularly valuable method in the definitive diagnosis of ruptured lung hydatid cysts. The definite diagnosis is based on the visualization of the endobronchial membrane during bronchoscopy or scolices in the bronchial aspirate. It can be also used to prevent complications such as bronchial dissemination and asphyxia due to intra-bronchial membrane pieces.
本研究旨在评估纤维支气管镜检查对于影像学表现与肺部肿块难以鉴别的破裂性肺包虫囊肿的诊断价值。
回顾性分析2000年1月至2018年1月期间连续45例接受纤维支气管镜检查以明确诊断的患者（男性27例，女性18例；平均年龄46.4±13.5岁；范围23至78岁），这些患者在进行放射诊断后接受了纤维支气管镜检查以确立明确诊断。记录患者的人口统计学和临床特征、术前诊断性检查、支气管镜检查结果及术后诊断等数据。
支气管镜检查最常见的表现为支气管内充血（n = 42）和脓性分泌物（n = 34）。最具特异性的表现是23例患者出现囊膜碎片。5例患者在支气管灌洗物中发现头节。1例患者在支气管灌洗物中同时检测到囊膜碎片和头节。28例患者（占62.2%）术前根据这些表现初步诊断为包虫囊肿。所有患者均通过开胸手术确诊为包虫囊肿。
支气管镜检查在破裂性肺包虫囊肿的明确诊断中是一种特别有价值的方法。明确诊断基于支气管镜检查时支气管内膜的可视化或支气管灌洗物中的头节。它还可用于预防诸如支气管播散和支气管内囊膜碎片导致的窒息等并发症。
