Calari Teresa, Petrarulo Simone, Dubini Alessandra, Piciucchi Sara, Ravaglia Claudia, Poletti Venerino
Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy.
Respiratory and Critical Care Unit IRCCS Azienda Ospedaliero-Universitaria di Bologna Bologna Italy.
Respirol Case Rep. 2024 May 15;12(5):e01385. doi: 10.1002/rcr2.1385. eCollection 2024 May.
EBUS-TBNA has represented a revolution in the diagnosis of intrathoracic pathologies, particularly in lung cancer staging, replacing more invasive methods such as mediastinoscopy. However, its role in diagnosing rare benign or malignant mediastinal disorders is still a matter of debate. Over the past few years, the role of EBUS-guided cryobiopsy has been increasingly emerging as an innovative and minimally invasive technique in diagnosing these disorders, with an excellent safety profile. In this case report, we present the case of a young man brought to our attention after already undergoing a non-diagnostic trans thoracic needle aspiration (TTNA) procedure for lung consolidations. In our department, he underwent an initial EBUS-TBNA procedure with inconclusive rapid on-site evaluation (ROSE), leading to the decision to perform an EBUS-guided cryobiopsy, which yielded a diagnosis of granulomatosis with polyangiitis without complications. This clinical case demonstrates that in specific contexts, EBUS-cryobiopsy represents an excellent diagnostic tool.
超声支气管镜引导下经支气管针吸活检术(EBUS-TBNA)在胸内病变的诊断中引发了一场革命,尤其是在肺癌分期方面,取代了诸如纵隔镜检查等侵入性更强的方法。然而,其在诊断罕见的良性或恶性纵隔疾病中的作用仍存在争议。在过去几年中,超声支气管镜引导下冷冻活检术的作用日益凸显,成为诊断这些疾病的一种创新且微创的技术,具有出色的安全性。在本病例报告中,我们介绍了一名年轻男性的病例,他在因肺部实变接受了未明确诊断的经胸针吸活检术(TTNA)后引起了我们的注意。在我们科室,他首先接受了超声支气管镜引导下经支气管针吸活检术,快速现场评估(ROSE)结果不明确,于是决定进行超声支气管镜引导下冷冻活检,最终诊断为肉芽肿性多血管炎,且未出现并发症。该临床病例表明,在特定情况下,超声支气管镜冷冻活检是一种出色的诊断工具。