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Kops SEP, Verhoeven RLJ, van der Heijden EFM. Case report: multiple lesions during navigation bronchoscopy; seen one, seen them all? AME Case Rep 2023; 7:2. [PMID: 36817708 PMCID: PMC9929662 DOI: 10.21037/acr-22-40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023]
Abstract
Background Peripheral pulmonary nodules are often detected as multiple nodules in one patient. Computed tomography (CT) guided transthoracic biopsy (TTNB) is the most widely implemented method for minimal invasive biopsy of pulmonary nodules, but generally only one nodule is sampled per procedure. Navigation bronchoscopy is an endobronchial procedure with very low complication rates, and uses high-end image guidance which allows for the sampling of multiple nodules in one session, while also allowing inspection of the central airways and endobronchial ultrasound (EBUS) guided staging in one session. This report presents a unique case with three different synchronous primary tumors treated with three different treatment modalities that highlights the added value of cone-beam CT guided navigation bronchoscopy (CBCT-NB) in the diagnostic work-up of suspected early-stage lung cancer. Case Description This case describes an asymptomatic patient with no history of prior lung cancer referred because of a shadow seen on a screening X-ray. CT and positron emission tomography (PET) showed two nodules for which a navigation procedure was performed. Both nodules were sampled, and on inspection, a third occult endobronchial lesion was also found. Pathology revealed three separate primary tumors, which were treated with three different treatment modalities: surgery, radiotherapy and endobronchial cryoablation. Current follow-up at 12 months shows no signs of recurrence. Conclusions This case highlights that synchronous primary malignancies do occur and require a patient tailored approach to minimize treatment related morbidity and optimize survival. To this goal, image guided navigation bronchoscopy allows for a full and complete diagnostic evaluation and can be combined with a staging EBUS in one single session.
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Zhu J, Liu R, Wu X, Li Q, Gong B, Shen Y, Ou Y, Li W. The value of narrow-band imaging bronchoscopy in diagnosing central lung cancer. Front Oncol 2022; 12:998770. [PMID: 36185220 PMCID: PMC9524255 DOI: 10.3389/fonc.2022.998770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Aims This research aimed to study the value of narrow-band imaging(NBI) in the diagnosis of central lung cancer. Materials and methods This study included 916 patients with clinical suspected of central lung cancer or follow-up of patients after curative lung cancer surgery. All of the patients were examined by Olympus Evis Lucera electronic bronchoscope system, any sites that were abnormal when viewed by white-light bronchoscopy (WLB) or NBI were biopsied, four to six biopsies were taken at each site of the abnormal region visualized as lesions, we record the endoscopic features of NBI and compared with histopathology results, to evaluate the diagnostic value of NBI for central lung cancer and the relationship between vascular patterns of NBI and histological types of lung cancer, and try to establish a multinomial logistic regression model for predicting the histological types of lung cancer. The biopsy specimens were examined by CD34 antibody through immunohistochemistry (IHC) method, CD34 marked microvessel density(MVD), compared the number of microvessels between benign and malignant diseases and the number between different histological types of lung cancer, to verify the results of NBI. Results NBI provided high sensitivity (91.7%), specificity (84.9%), positive predictive value (97.6%), negative predictive value (61.5%), and agreement rate (90.7%). The predominant vascular patterns in the well-defined histological types of lung cancer were dotted blood vessels (121 patients), tortuous blood vessels (248 patients), and abrupt-ending blood vessels (227 patients). Logistic regression analysis of the results showed that smoking status of the patient, combined with vascular patterns under NBI, and age partly affect the histological types of lung cancer. Conclusions NBI is highly accurate for the diagnosis of central lung cancer.
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Affiliation(s)
- Juanjuan Zhu
- Provincial Key Laboratory of Respiratory Disease in Anhui, Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Center for Clinical Medicine of Respiratory Disease (Tumor) in Anhui, Department of Respiratory Disease, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Respiratory Disease, Dangshan County People’s Hospital, Dangshan, China
| | - Rui Liu
- Provincial Key Laboratory of Respiratory Disease in Anhui, Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Center for Clinical Medicine of Respiratory Disease (Tumor) in Anhui, Department of Respiratory Disease, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xiancheng Wu
- Provincial Key Laboratory of Respiratory Disease in Anhui, Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Center for Clinical Medicine of Respiratory Disease (Tumor) in Anhui, Department of Respiratory Disease, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qin Li
- Provincial Key Laboratory of Respiratory Disease in Anhui, Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Center for Clinical Medicine of Respiratory Disease (Tumor) in Anhui, Department of Respiratory Disease, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Department of Respiratory Disease, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Beilei Gong
- Provincial Key Laboratory of Respiratory Disease in Anhui, Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Center for Clinical Medicine of Respiratory Disease (Tumor) in Anhui, Department of Respiratory Disease, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Yuanbing Shen
- Provincial Key Laboratory of Respiratory Disease in Anhui, Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Center for Clinical Medicine of Respiratory Disease (Tumor) in Anhui, Department of Respiratory Disease, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Yurong Ou
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Wei Li
- Provincial Key Laboratory of Respiratory Disease in Anhui, Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- Center for Clinical Medicine of Respiratory Disease (Tumor) in Anhui, Department of Respiratory Disease, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- *Correspondence: Wei Li,
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He Z, Wang P, Liang Y, Fu Z, Ye X. Clinically Available Optical Imaging Technologies in Endoscopic Lesion Detection: Current Status and Future Perspective. J Healthc Eng 2021; 2021:7594513. [PMID: 33628407 PMCID: PMC7886528 DOI: 10.1155/2021/7594513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/13/2021] [Accepted: 01/27/2021] [Indexed: 01/02/2023]
Abstract
Endoscopic optical imaging technologies for the detection and evaluation of dysplasia and early cancer have made great strides in recent decades. With the capacity of in vivo early detection of subtle lesions, they allow modern endoscopists to provide accurate and effective optical diagnosis in real time. This review mainly analyzes the current status of clinically available endoscopic optical imaging techniques, with emphasis on the latest updates of existing techniques. We summarize current coverage of these technologies in major hospital departments such as gastroenterology, urology, gynecology, otolaryngology, pneumology, and laparoscopic surgery. In order to promote a broader understanding, we further cover the underlying principles of these technologies and analyze their performance. Moreover, we provide a brief overview of future perspectives in related technologies, such as computer-assisted diagnosis (CAD) algorithms dealing with exploring endoscopic video data. We believe all these efforts will benefit the healthcare of the community, help endoscopists improve the accuracy of diagnosis, and relieve patients' suffering.
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Affiliation(s)
- Zhongyu He
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
| | - Peng Wang
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
| | - Yuelong Liang
- Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Zuoming Fu
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
| | - Xuesong Ye
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
- State Key Laboratory of CAD and CG, Zhejiang University, Hangzhou 310058, China
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Tomono H, Soda H, Fukuda Y, Tanaka Y, Ono S, Shimada M, Iwasaki K, Hisanaga M, Yamaguchi H, Mukae H. Intrathoracic amyloid tumors that presented as yellowish multinodular endobronchial protrusions with irregular vascularity and easy bleeding. Thorac Cancer 2019; 10:2026-2030. [PMID: 31379060 PMCID: PMC6775019 DOI: 10.1111/1759-7714.13159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/10/2019] [Accepted: 07/13/2019] [Indexed: 11/30/2022] Open
Abstract
Immunoglobulin light‐chain (AL) amyloidosis is a monoclonal plasma cell neoplasm that has a tendency to bleed easily. However, the potential risks of transbronchial biopsy in such cases have not been fully proven. Here, we report a case of parotid and intrathoracic AL amyloid tumors that presented as endobronchial protrusions that bled easily. Bronchoscopy under conventional white light and narrow band imaging revealed yellowish multinodular protrusions, in which irregular tortuous or dotted vessels were observed. Unexpectedly, biopsy of the lesion resulted in persistent bleeding. The biopsy specimen showed a large amount of amyloid deposition and calcification directly under the bronchial epithelium, as well as amyloid deposits in the blood vessel walls. In patients suspected to have amyloidosis, the presence of yellowish multinodular endobronchial protrusions, particularly with irregular vascularity, should prompt careful attention to avoid fatal postprocedural bleeding.
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Affiliation(s)
- Hiromi Tomono
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Hiroshi Soda
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Yuichi Fukuda
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Yasuhiro Tanaka
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Sawana Ono
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Midori Shimada
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Keisuke Iwasaki
- Department of Pathology, Sasebo City General Hospital, Nagasaki, Japan
| | - Masashi Hisanaga
- Department of Otolaryngology, Sasebo City General Hospital, Nagasaki, Japan
| | - Hiroyuki Yamaguchi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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