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Bhagya Sudheer, Manisha Agarwal, Deepa Sharma, Ravi Mehta, Kalpana Babu
PURPOSE: To report our experience of using Endobronchial ultrasound-guided transbronchial lymph node aspiration (EBUS-TBNA) in assessing the etiology in uveitis from two tertiary eye-care centers in India. MATERIALS & METHODS: Retrospective interventional case series. RESULTS: A total of 99 patients of uveitis who underwent EBUS-TBNA were included in the study. Mycobacterium tuberculosis (MTb) was detected on culture in 5 cases, 3 cases by polymerase chain reaction and caseating granulomas in 25 cases...
March 15, 2018: Ocular Immunology and Inflammation
Yuki Shiina, Yuichi Sakairi, Hironobu Wada, Hajime Tamura, Taiki Fujiwara, Takahiro Nakajima, Hidemi Suzuki, Masako Chiyo, Masayuki Ota, Satoshi Ota, Yukio Nakatani, Ichiro Yoshino
BACKGROUND: Sclerosing pneumocytoma is a rare lung tumor that is usually recognized as a solitary nodule in the lung. Surgical removal is recommended; however, its clinical diagnosis is still an issue because it is difficult to differentiate from lung adenocarcinomas using a tiny sample obtained from biopsy. CASE PRESENTATION: We report a case of pulmonary sclerosing pneumocytoma located in the upper lobe of the right lung of a 34-year-old woman, which was diagnosed before surgery by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)...
March 9, 2018: Surgical Case Reports
Karan Madan, Anant Mohan, Ritesh Agarwal, Vijay Hadda, Gopi C Khilnani, Randeep Guleria
Background: There is a lack of contemporaneous data on the practices of flexible bronchoscopy in India. Aim: The aim of the study was to study the prevalent practices of flexible bronchoscopy across India. Methods: The "Indian Bronchoscopy Survey" was a 98-question, online survey structured into the following sections: general information, patient preparation and monitoring, sedation and topical anesthesia, procedural/technical aspects, and bronchoscope disinfection/staff protection...
March 2018: Lung India: Official Organ of Indian Chest Society
Abhishek Biswas, Marino E Leon, Peter Drew, Sebastian Fernandez-Bussy, Larissa V Furtado, Michael A Jantz, Hiren J Mehta
BACKGROUND: Pembrolizumab was recently approved as a first line agent for metastatic NSCLC in patients with high programmed death-ligand 1 (PD-L1) expression. OBJECTIVES: Since a significant portion of lung cancer is diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS TBNA); there is a need for PD-L1 testing in these specimens. However, to date few studies have evaluated performance of cytology specimens from EBUS TBNA for PD-L1 analysis...
February 24, 2018: Diagnostic Cytopathology
Honghai Ma, Zhou An, Pinghui Xia, Jinlin Cao, Qiqi Gao, Guoping Ren, Xing Xue, Xianhua Wang, Zhehao He, Jian Hu
This study aimed to semi-quantitatively evaluate the elastographic imaging color distribution of mediastinal and hilar lymph nodes (LNs), and explored its utility in helping define malignant and benign LNs for lung cancer patients. We prospectively collected patients who underwent preoperative mediastinal staging of suspected lung cancer by EBUS-TBNA. We analyzed the elastography color distribution of each LN and calculated the blue color proportion (BCP). The LN elastographic patterns were compared with the final EBUS-TBNA pathological results...
February 23, 2018: Scientific Reports
David Fielding, Noriaki Kurimoto
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS TBNA) is fundamental to the diagnosis of lung cancer, as many patients present with more advanced stages of lung cancer, with enlarged hilar and mediastinal lymph nodes. It also represents a way to sample pulmonary masses directly to make the diagnosis, whereby no other accessible tissue is present and the mass sits adjacent to a large central airway. Very importantly also, EBUS TBNA is the widely accepted first procedure in lung cancer staging...
March 2018: Clinics in Chest Medicine
Gonzalo Labarca, Iván Caviedes, Erik Folch, Adnan Majid, Sebastián Fernández-Bussy
In the last years, several techniques have been developed to obtain a prompt diagnosis or rule out lung cancer. Endobronchial ultrasound- guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure with a high diagnostic yield for mediastinal and central pulmonary lesions. This procedure is especially useful for lung cancer diagnosis and mediastinal staging. Two different types of EBUS are currently available: Radial EBUS and lineal EBUS. Each one has technical differences together with a range of clinical indications...
September 2017: Revista Médica de Chile
Reema Bansal, Amod Gupta, Ritesh Agarwal, Mohit Dogra, Garvit Bhutani, Vishali Gupta, M R Dogra, Deeksha Katoch, Ashutosh Nath Aggarwal, Aman Sharma, Raje Nijhawan, Ritambara Nada, Uma Nahar Saikia, Pranab Dey, Digambar Behera
PURPOSE: To report the role of CT chest and cytology in suspected tubercular and sarcoid uveitis. METHODS: This is a retrospective, interventional case series of 376 uveitis patients with suspected ocular tuberculosis (TB)/sarcoidosis seen between January 2010 and April 2015 at the Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh. All underwent CT chest, and had following inclusion criteria: (1) Presence of active granulomatous anterior/intermediate/posterior uveitis or panuveitis; (2) a documented tuberculin skin test/QuantiFERON-TB Gold test; (3) all other causes of infectious/non-infectious uveitis ruled out...
February 8, 2018: Ocular Immunology and Inflammation
Kaid Darwiche, Filiz Özkan, Celina Wolters, Stephan Eisenmann
Endobronchial ultrasound (EBUS) has revolutionized the diagnosis of lung cancer over the last decade. This minimally invasive diagnostic method has also become increasingly important in the case of other diseases such as sarcoidosis, thereby helping to avoid unnecessary diagnostic interventions. This review article provides an update regarding EBUS and discusses current and future developments of this method.
February 2018: Ultraschall in der Medizin
David Jonathan Heineman, Naomi Beck, Michael Wilhelmus Wouters, Thomas Jan van Brakel, Johannes Marlene Daniels, Wilhelmina Hendrika Schreurs, Chris Dickhoff
OBJECTIVE: Optimal treatment selection for patients with non-small cell lung cancer (NSCLC) depends on the clinical stage of the disease. Particularly patients with mediastinal lymph node involvement (stage IIIA-N2) should be identified since they generally do not benefit from upfront surgery. Although the standardized preoperative use of PET-CT, EUS/EBUS and/or mediastinoscopy identifies most patients with mediastinal lymph node metastasis, a proportion of these patients is only diagnosed after surgery...
January 9, 2018: European Journal of Surgical Oncology
D Basille, C Hybiak, C Dayen, B Toublanc, Y Douadi, G Francois, I Rault, C Andrejak, P Berna, V Jounieaux
INTRODUCTION: Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) has undergone a large increase in France since 2007. The aim is to study the evolution of the indications for EBUS-TBNA in our region during the period 2008-2013. MATERIAL AND METHODS: We conducted a retrospective observational study including all the patients who underwent an EBUS-TBNA procedure in Picardie from 2008 to 2013. The respective proportion for each indication was noted...
January 23, 2018: Revue des Maladies Respiratoires
Samy Lachkar, Jean-Marc Baste, Luc Thiberville, Christophe Peillon, Philippe Rinieri, Nicolas Piton, Florian Guisier, Mathieu Salaun
BACKGROUND: Minimally invasive surgery of pulmonary nodules allows suboptimal palpation of the lung compared to open thoracotomy. OBJECTIVE: The objective of this study was to assess endoscopic pleural dye marking using radial endobronchial ultrasound (r-EBUS) and virtual bronchoscopy to localize small peripheral lung nodules immediately before minimally invasive resection. METHODS: The endoscopic procedure was performed without fluoroscopy, under general anesthesia in the operating room immediately before minimally invasive surgery...
January 25, 2018: Respiration; International Review of Thoracic Diseases
Jun Zhu, Feng Tang, Ye Gu
Background: It is difficult to collect peripheral lung cancer samples. This study analyzed the applicability of endobronchial ultrasonography with a guide sheath (EBUS-GS) and computed tomography-guided transthoracic needle aspiration (CT-TTNA) for the diagnosis of peripheral lung cancer. Methods: A prospective analysis of peripheral lung cancer patients was performed. The study included 150 cases in the EBUS-GS group and 177 cases in the CT-TTNA group. The diagnostic rate, pathological type, genetic status and complications were analyzed...
2018: Therapeutic Advances in Medical Oncology
Catalina Lizama, Neli S Slavova-Azmanova, Martin Phillips, Michelle L Trevenen, Ian W Li, Claire E Johnson
BACKGROUND Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and guide sheath (EBUS-GS) are gaining popularity for diagnosis and staging of lung cancer compared to CT-guided transthoracic needle aspiration (CT-TTNA), blind fiber-optic bronchoscopy, and mediastinoscopy. This paper aimed to examine predictors of higher costs for diagnosing and staging lung cancer, and to assess the effect of EBUS techniques on hospital cost. MATERIAL AND METHODS Hospital costs for diagnosis and staging of new primary lung cancer patients presenting in 2007-2008 and 2010-2011 were reviewed retrospectively...
January 29, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Raj A Shah, Jose J Vempilly, Shaikh M Noor Ul Husnain, Pravachan Hegde
Coccidioidomycosis causes significant morbidity in endemic areas. In the absence of sensitive diagnostic serologic testing, clinicians have increasingly relied on lung and lymph node biopsies for diagnosis. Recently, endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been shown to be an excellent sampling method for the diagnosis and staging of lung cancers, especially when combined with endoscopic ultrasound guided fine needle aspiration (EUS-FNA). We present 13 consecutive cases where EBUS-TBNA and/or EUS-FNA of pulmonary lymph nodes were performed as part of the workup for pulmonary coccidioidomycosis...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
Danai Khemasuwan, Krittika Teerapuncharoen, David C Griffin
BACKGROUND: The propofol use for moderate sedation (MS) during endobronchial ultrasound (EBUS) bronchoscopy is primarily restricted for use by an anesthesiologist because of safety concerns. The goals of this study were to demonstrate the safety and the diagnostic yield of the use of propofol by bronchoscopists and trained endoscopy nurses during EBUS bronchoscopy without intubation. METHODS: We tested a bolus propofol administration protocol targeting MS for EBUS bronchoscopy...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
Ravindra M Mehta, Pavankumar R Biraris, Vallandramam Pattabhiraman, Arjun Srinivasan, Abhinav Singla, Sunil Kumar, Michael Cutaia
BACKGROUND: Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) has revolutionized the diagnostic approach to mediastinal diseases. Lesions located lateral to the pulmonary artery (trans-PA, Station 5), or in the lumen of the PA (intra-PA) are in the 'blind-spot' of EBUS. OBJECTIVES: We describe a case series where EBUS guided trans-pulmonary or intra-pulmonary aspiration (EBUS-TIPNA) was used for diagnosis. METHODS: Retrospective analysis of 10 patients who had EBUS-TIPNA over 3 years in 2 centres...
January 13, 2018: Clinical Respiratory Journal
Samantha Herath, Elaine Yap
In diagnosing peripheral pulmonary lesions (PPL), radial endobronchial ultrasound (R-EBUS) is emerging as a safer method in comparison to CT-guided biopsy. Despite the better safety profile, the yield of R-EBUS remains lower (73%) than CT-guided biopsy (90%) due to the smaller size of samples. We adopted a hybrid method by adding cryobiopsy via the R-EBUS Guide Sheath (GS) to produce larger, non-crushed samples to improve diagnostic capability and enhance molecular testing. We report six prospective patients who underwent this procedure in our institution...
February 2018: Respirology Case Reports
Midori Toriyama, Etsuko Tagaya, Tomoko Yamamoto, Mitsuko Kondo, Yoji Nagashima, Jun Tamaoki
A 65-year-old man was diagnosed with granulomatosis with polyangiitis (GPA) at the age of 47, when cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA) serology was positive, and he had multiple nodular shadows in both lungs. He had been treated with prednisolone, cyclophosphamide (CPA) and plasma exchange. At the age of 64, a nodular shadow was newly detected in the right lower lung field and serum tumour marker increased. Subsequent positron emission tomography/computed tomography scan demonstrated accumulations of fluorodexyglucose (FDG) in the same area, mediastinum lymph nodes, thoracic wall, right iliac bone, and right retroperitoneum...
February 2018: Respirology Case Reports
L Zhang, M Li, S He, R Tong, J Q Zhu, G Q Wang
Objective: To explore the diagnostic value of endobronchial ultrasonography with a guide sheath (EBUS-GS) for peripheral pulmonary ground glass opacity (GGO). Methods: The clinical data of 27 consecutive patients with 27 GGOs diagnosed by EBUS-GS between November 2014 to December 2015 in our Cancer Hospital were retrospectively analyzed. The average age of these 27 patients, including 9 males and 18 females, was 59±11 years. The median lesion size of the 27 GGOs was 2.9±1.2 cm, including 24 mixed GGOs and 3 pure GGOs...
November 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
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