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Lung bronchoscopy

Hongyang Lu, Bo Chen, Jing Qin, Fajun Xie, Na Han, Zhiyu Huang
The present study describes the case of a 48-year-old man who was diagnosed with lung adenocarcinoma with an epidermal growth factor receptor (EGFR) 21 L858R mutation. The patient received surgery and adjuvant chemotherapy. When multiple lung metastases appeared, icotinib was administered. Following resistance to icotinib, biopsy by endobroncheal ultrasonography for a right lung hilar lymph node revealed transformation to a neuroendocrine morphology. Neuron-specific enolase (NSE) levels were elevated, accompanied with disease progression following transformation to the neuroendocrine morphology...
April 2018: Oncology Letters
Shahid Husain, Archana Bhaskaran, Coleman Rotstein, Yanhong Li, Alyajahan Bhimji, Rhea Pavan, Deepali Kumar, Atul Humar, Shaf Keshavjee, Lianne G Singer
BACKGROUND: The optimal strategy for prevention of invasive fungal infections in lung transplant recipients remains undetermined. We studied strategies based on bronchoalveolar lavage fungal culture and galactomannan for prevention of invasive aspergillosis in lung transplant recipients. METHODS: Consecutive lung transplant recipients were evaluated during the period January 2010 to September 2014. Rates of invasive aspergillosis and all-cause mortality were recorded at 1 year...
February 16, 2018: Journal of Heart and Lung Transplantation
David Chi-Leung Lam, Hoi-Hin Kwok, Wai-Cho Yu, Fanny Wai-San Ko, Cheuk-Yin Tam, Arthur Chun-Wing Lau, Daniel Yee-Tak Fong, Mary Sau-Man Ip
BACKGROUND: Club cell protein-16 (CC16) expression has been associated with smoking-related lung function decline. The study hypothesis was that CC16 expression in both serum and bronchial epithelium is associated with lung function decline in smokers, and exposure to cigarette smoke will lead to reduction in CC16 expression in bronchial epithelial cells. METHODS: In a cohort of community-based male Chinese subjects recruited for lung function test in 2000, we reassessed their lung function ten years later and measured serum levels of CC16...
March 16, 2018: BMC Pulmonary Medicine
Matthew T Koroscil, Andrew Skabelund
Introduction: Blastomyces dermatitidis is a dimorphic fungus endemic to the Mississippi River valley. We describe a rare case of chronic pulmonary blastomycosis complicated by large pulmonary cavitation in a young service member who was misdiagnosed with active pulmonary tuberculosis. Case Presentation: A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL)...
March 14, 2018: Military Medicine
Christopher Mallow, Jeffrey Thiboutot, Roy Semaan, Margaret M Hayes, Russell Hales, Ashwin Ram, David Feller-Kopman, Hans Lee, Lonny Yarmus
BACKGROUND AND OBJECTIVE: Malignant airway obstruction (MAO), a common complication of patients with advanced lung cancer, causes debilitating dyspnoea and poor quality of life. Two common interventions used in the treatment of MAO include bronchoscopy with airway stenting and external beam radiotherapy (EBRT). Data are limited regarding their clinical effectiveness and overall effect on survival. METHODS: A retrospective chart review of patients treated with airway stenting and/or EBRT at the Johns Hopkins Hospital for MAO between July 2010 and January 2017 was reviewed...
March 12, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Emine Caliskan, Shamil Aliyev, Hatice Arioz Habibi, Zuhal Bayramoglu, Ravza Yilmaz, Ibrahim Adaletli
OBJECTIVE: To evaluate the utility of radiodensity ratio between lungs on chest X-ray for the diagnosis of radiolucent foreign body aspiration (FBA) in children. METHODS: X-rays of 33 patients with confirmed diagnosis of FBA by bronchoscopy were compared to 66 control patients. We divided the study group into three subgroups: symmetric (13-patients), right-oblique (RO;12-patients) and left-oblique (LO;8-patients). RESULTS: When we compared FBA-symmetric-subgroup to symmetric-control-group, FBA-RO-subgroup to RO-control-group and FBA-LO-subgroup to LO-control-group, radiodensity ratios were significantly higher in the FBA subgroups...
March 4, 2018: Clinical Imaging
Haisam Abid, Junaid Khan, Nazir Lone
We report a case of Hodgkin's lymphoma presenting as an endobronchial mass in a 40-year-old man with history of 8 months of non-specific symptoms like cough, fatigue and weight loss. Initially he was treated with broad-spectrum antibiotics for suspicion of pneumonia without recovery. Radiographic work-up showed cavitary consolidation of the upper lobe of the left lung, followed by bronchoscopy which showed obstructing mass of the upper lobe of the left lung mimicking primary lung carcinoma. Immunohistochemical staining of the specimen was suggestive of Hodgkin's lymphoma...
March 9, 2018: BMJ Case Reports
Daizo Yaguchi, Motoshi Ichikawa, Noriko Inoue, Daisuke Kobayashi, Masato Shizu, Naoyuki Imai
A lesion in a 73-year-old woman that was suspected to be right lung cancer was biopsied under ultrasound-guided bronchoscopy with a guide sheath. The procedure was completed without a noticeable problem, but after 3 days, it was found that the tip of the ultrasonic probe sheath was broken and that the broken fragment was missing. Based on the concern that the fragment had been left in the lung, the patient was examined by computed tomography scan 4 days after the biopsy, and bronchoscopy was repeated 38 days after the biopsy, but no fragment was detected...
May 2018: Respirology Case Reports
Jiyoun Yeo, Diego A Morales, Tian Chen, Erin L Crawford, Xiaolu Zhang, Thomas M Blomquist, Albert M Levin, Pierre P Massion, Douglas A Arenberg, David E Midthun, Peter J Mazzone, Steven D Nathan, Ronald J Wainz, Patrick Nana-Sinkam, Paige F S Willey, Taylor J Arend, Karanbir Padda, Shuhao Qiu, Alexei Federov, Dawn-Alita R Hernandez, Jeffrey R Hammersley, Youngsook Yoon, Fadi Safi, Sadik A Khuder, James C Willey
BACKGROUND: There is a need for more powerful methods to identify low-effect SNPs that contribute to hereditary COPD pathogenesis. We hypothesized that SNPs contributing to COPD risk through cis-regulatory effects are enriched in genes comprised by bronchial epithelial cell (BEC) expression patterns associated with COPD. METHODS: To test this hypothesis, normal BEC specimens were obtained by bronchoscopy from 60 subjects: 30 subjects with COPD defined by spirometry (FEV1/FVC < 0...
March 5, 2018: BMC Pulmonary Medicine
Chang-Guo Wang, Da-Xiong Zeng, Jian-An Huang, Jun-Hong Jiang
RATIONALE: The mechanism of the first-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) acquired resistance included T790M mutation, cellular-mesenchymal to epithelial transition factor (MET) or EGFR amplification, PIK3CA mutation, and transformation to small cell lung cancer. MET amplification accounted for only about 5% of the resistance cases. PATIENTS CONCERNS: Few report detected MET amplification in pleural effusion. Here, we reported 2 lung adenocarcinoma cases with MET amplification in pleural effusion rapidly responded to crizotinib after EGFR-TKIs acquired resistance...
January 2018: Medicine (Baltimore)
Akira Yokoyama, Hidenori Kage, Yuki Ohama, Tomoaki Sato, Naoya Miyashita, Satoshi Noguchi, Shu Okugawa, Yasuhiro Yamauchi, Kyoji Moriya, Takahide Nagase
Identification of microorganisms by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been widely accepted. However, the significance of MALDI-TOF MS for identifying mycobacteria, particularly rare nontuberculous mycobacteria, has not been established. M. heckeshornense is one such bacteria, and distinguishing it from M. xenopi is difficult. The patient was a 40-year-old man with Behҫet's disease who had started treatment with prednisolone and azathioprine. A lung nodule in the right lower lobe was pointed out, and it increased in size 6 months later...
March 1, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Justyna Maria Torbiarczyk, Patryk Aleksander Sobczak, Katarzyna Krystyna Torbiarczyk, Joanna Miłkowska-Dymanowska, Adam Antczak, Paweł Górski, Adam J Białas, Wojciech J Piotrowski
INTRODUCTION: Fiber-optic bronchoscopy (FOB) is commonly performed in the first line in diagnostic process of haemoptysis. However, lots of evidences suggest that in haemoptysis FOB do not always provide additional, useful information to radiological diagnostics. Therefore, this study aimed to evaluate the validity of performing FOB as a method of choice in first line diagnostics of haemoptysis. MATERIAL AND METHODS: Data comprised consecutively collected results from patients referred for FOB assessment for clinical purposes were retrospectively analysed...
2018: Advances in Respiratory Medicine
Karalynn Otterness, Christine Ahn, Jeffrey Nusbaum, Nachi Gupta
Smoke inhalation injury portends increased morbidity and mortality in fire-exposed patients. Upper airway thermal burns, inflammation from lower airway irritants, and systemic effects of carbon monoxide and cyanide can contribute to injury. A standardized diagnostic protocol for inhalation injury is lacking, and management remains mostly supportive. Clinicians should maintain a high index of suspicion for concomitant traumatic injuries. Diagnosis is mostly clinical, aided by bronchoscopy and other supplementary tests...
March 1, 2018: Emergency Medicine Practice
Karalynn Otterness, Christine Ahn
Smoke inhalation injury portends increased morbidity and mortality in fire-exposed patients. Upper airway thermal burns, inflammation from lower airway irritants, and systemic effects of carbon monoxide and cyanide can contribute to injury. A standardized diagnostic protocol for inhalation injury is lacking, and management remains mostly supportive. Clinicians should maintain a high index of suspicion for concomitant traumatic injuries. Diagnosis is mostly clinical, aided by bronchoscopy and other supplementary tests...
March 2018: Emergency Medicine Practice
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
Alexander C Chen, Colin T Gillespie
PURPOSE: Bronchoscopy for peripheral pulmonary lesions continues to present challenges to clinicians. One potential limitation may be the inability to advance conventional bronchoscopes into close proximity of peripheral lesions prior to biopsy. This study was performed to assess the reach of a robotic endoscopic system within human cadaveric lungs compared to conventional thin bronchoscopes. DESCRIPTION: All segmental bronchi (RB1-10, LB1-10) were accessed in two human cadavers using a conventional thin bronchoscope and robotic endoscope of identical outer diameter...
February 24, 2018: Annals of Thoracic Surgery
Toshihiro Ikeda, Jun Nakano, Hiroyasu Yokomise
A 73-year-old man was injured after crashing his automobile into a concrete wall, and was admitted to our hospital with breathing difficulties. Chest computed tomography showed extensive mediastinal emphysema, right traumatic pneumothorax, and a suspected tracheal injury at the membranous region. Because of the associated tracheomalacia, the site of the tracheal injury was difficult to find by bronchoscopy. In addition, as the patient's respiratory condition was stable, surgical treatment was not chosen. Due to the continuous air leakage from the right lung, the patient underwent surgery after mediastinal and subcutaneous emphysema improved...
February 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Lenard Tai Win Cheng, Tiong Beng Sim, Win Sen Kuan
BACKGROUND: Critical central airway obstruction (CAO) requires emergent airway intervention, but current guidelines lack specific recommendations for airway management in the emergency department (ED) while awaiting rigid bronchoscopy. There are few reports of the use of noninvasive ventilation (NIV) in tracheomalacia, but its use as a temporizing treatment option in fixed, malignant CAO has not, to the best of our knowledge, been reported. CASE REPORT: An 84-year-old woman presented to the ED in respiratory distress, too breathless to speak and using her accessory muscles of respiration, with bilateral rhonchi throughout the lung fields...
February 23, 2018: Journal of Emergency Medicine
Waseem Hajjar, Iftikhar Ahmed, Samiha Aljetaily, Tarfah Al-Obaidan, Adnan W Hajjar
Diagnosing endobronchial tuberculosis (EBTB) can be difficult due to the lack of specific signs and symptoms that differentiate it from other respiratory diseases, such as lung tumors. We hereby report a case of a very rare presentation of tuberculosis (TB) in a patient who presented with a dry cough and significant weight loss for 3 months. Chest X-ray and CT scan of the chest showed partial atelectasis and a segmental collapse of the right upper lobe and tumor-like arising from its bronchus along with a large right para-tracheal mediastinal lymphadenopathy, mimicking a metastatic (N2) disease...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Arunava Ghosh, Raymond C Coakley, Teresa Mascenik, Temperance R Rowell, Eric S Davis, Keith Rogers, Megan J Webster, Hong Dang, Laura E Herring, M Flori Sassano, Alessandra Livraghi-Butrico, Scott K Van Buren, Lee M Graves, Melissa A Herman, Scott H Randell, Neil E Alexis, Robert Tarran
RATIONAL: E-cigarettes vaporize propylene glycol/vegetable glycerin (PG/VG), nicotine and flavorings. However, the long-term health effects of exposing lungs to vaped e-liquids are unknown. OBJECTIVES: To determine the effects of chronic vaping on pulmonary epithelia. METHODS: We performed research bronchoscopies on healthy non-smokers, cigarette smokers and e-cigarettes users (vapers) and obtained bronchial brush biopsies and lavage samples from these subjects for proteomic investigation...
February 26, 2018: American Journal of Respiratory and Critical Care Medicine
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