Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2021 Apr 23;100(16):e25515. doi: 10.1097/MD.0000000000025515.
Ground-glass opacity nodules (GGNs) are a computed tomography (CT) finding suggestive of lung cancer. Conventional bronchoscopy with brush cytology is a simple diagnostic modality but has a low diagnostic yield for peripheral lesions, especially peripheral GGNs. Therefore, maximizing the detection rate of bronchoscopic brushings should be a key objective. We report a case of a subpleural ground glass opacity (GGO) with a cytological diagnosis of adenocarcinoma by bronchoscopic brushing guided by manual mapping navigation.
A 46-year-old man was hospitalized for GGO in the right lung. Follow-up CT revealed a subpleural nodule sized 1.2 cm × 0.9 cm in the superior segment of the right lower lobe.
CT findings of the patient's nodule were suggestive of malignancy.
The patient underwent conventional bronchoscopy combined with brushing guided by manual mapping navigation, with subsequent cytological diagnosis of adenocarcinoma. The patient then underwent right lower lobectomy with mediastinal lymph node dissection.
There were no postoperative complications. Postoperative pathological examination showed lung adenocarcinoma with lepidic and acinar growth without visceral pleural invasion (pT1aN0M0, IA1).
Exfoliated cells present in peripheral GGNs are rarely detected on brush sampling. However, use of a manual mapping navigation system may help increase the sensitivity of conventional bronchoscopic brushing for the diagnosis of peripheral pulmonary lesions.
磨玻璃密度结节（GGNs）是 CT 发现的肺癌提示性特征。传统的支气管镜刷检细胞学是一种简单的诊断方式，但对周围病变，尤其是周围 GGNs 的诊断率较低。因此，最大限度地提高支气管镜刷检的检出率应该是一个关键目标。我们报告了一例亚胸膜下磨玻璃密度（GGO），通过支气管镜刷检并结合手动导航定位，细胞学诊断为腺癌。
一名 46 岁男性因右肺 GGO 住院。随访 CT 显示右下叶上段胸膜下 1.2×0.9cm 大小的结节。
患者结节的 CT 表现提示恶性肿瘤。
患者接受了常规支气管镜检查，结合手动导航定位引导下的刷检，随后细胞学诊断为腺癌。患者随后接受了右下肺叶切除术和纵隔淋巴结清扫术。
无术后并发症。术后病理检查显示肺腺癌，具有贴壁和腺泡生长方式，无脏层胸膜侵犯（pT1aN0M0，IA1）。
刷检很少能检测到周围 GGNs 中的脱落细胞。然而，使用手动导航系统可能有助于提高常规支气管镜刷检对周围肺部病变的诊断敏感性。
