Gonuguntla Hari Kishan, Vidyasagar Belgundi Preeti, Shah Milap, Radia Sejal B, Tripathi Somesh, Poletti Venerino
Division of Interventional Pulmonology Yashoda Hospitals Hyderabad India.
Department of Laboratory Medicine Yashoda Hospitals Hyderabad India.
Respirol Case Rep. 2025 Feb 1;13(2):e70103. doi: 10.1002/rcr2.70103. eCollection 2025 Feb.
The current standard for determining sample adequacy during Endobronchial Ultrasound guided Mediastinal Sampling is ROSE (Rapid on-site Evaluation) on samples obtained by Fine needle Aspiration. There is an increasing interest in Mediastinal Lymph node cryobiopsy, where tissue samples are obtained using a 1.1 mm cryoprobe. Rapid onsite evaluation on cryobiopsy samples can also be performed by imprint cytology. This proof-of-concept study explores the use of Viva Scope 2500 for rapid on-site digital histopathological evaluation of Endobronchial Ultrasound (EBUS) guided mediastinal lymph node cryobiopsy samples. Confocal Laser Microscopy allows for high-resolution imaging and expedites diagnosis. The study involved four cases of mediastinal lymph node cryobiopsy, and the samples obtained were subjected to rapid digital histopathological examination by Viva Scope 2500 (confocal laser microscopy), enabling lesion in tool confirmation and the results obtained were compared with the final conventional histopathology results. Confocal Laser microscopy by Viva Scope 2500 was found to be comparable to conventional histopathology, superior to conventional histopathology in providing rapid on-site diagnosis minimising the time to diagnosis, with added advantage of better sampled tissue preservation for downstream molecular analysis. RODE reduces procedural time and increases confidence in the operator during mediastinal lymph node sampling enabling lesion in tool confirmation. RODE is a better alternative to ROSE and conventional histopathology decreasing the time to diagnosis.
目前，在支气管内超声引导下纵隔取样过程中确定样本充足性的标准是对细针穿刺获取的样本进行现场快速评估（ROSE）。人们对纵隔淋巴结冷冻活检的兴趣与日俱增，在冷冻活检中使用1.1毫米的冷冻探头获取组织样本。冷冻活检样本的快速现场评估也可通过印片细胞学进行。这项概念验证研究探索了使用Viva Scope 2500对支气管内超声（EBUS）引导下的纵隔淋巴结冷冻活检样本进行快速现场数字组织病理学评估。共聚焦激光显微镜可实现高分辨率成像并加快诊断速度。该研究纳入了4例纵隔淋巴结冷冻活检病例，对获取的样本通过Viva Scope 2500（共聚焦激光显微镜）进行快速数字组织病理学检查，以确认工具中的病变，并将所得结果与最终的传统组织病理学结果进行比较。结果发现，Viva Scope 2500的共聚焦激光显微镜检查结果与传统组织病理学相当，在提供快速现场诊断、缩短诊断时间方面优于传统组织病理学，还有利于更好地保存取样组织以供下游分子分析。在纵隔淋巴结取样过程中，快速在线诊断（RODE）减少了操作时间，增强了操作人员的信心，能够在工具中确认病变。RODE是ROSE和传统组织病理学的更好替代方法，可缩短诊断时间。
