scholarly journals A Case of Immunoglobulin G4 (IgG4)-Related Disease Diagnosed by Transbronchial Lung Biopsy and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

2014 ◽  
Vol 36 (4) ◽  
pp. 237-242 ◽  
Author(s):  
Hiroshi ISHIMOTO ◽  
Kazuhiro YATERA ◽  
Ikuko SHIMABUKURO ◽  
Yasumasa MATSUKI ◽  
Tetsuya HANAKA ◽  
...  
Keyword(s):  
Lung Biopsy ◽  
Needle Aspiration ◽  
Transbronchial Lung Biopsy ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Immunoglobulin G4 ◽  
Related Disease ◽  
Igg4 Related Disease

scholarly journals Modern bronhoscopic diagnosis of sarcoidosis

2013 ◽  
Vol 66 (suppl. 1) ◽  
pp. 17-21
Author(s):  
Spasoje Popevic ◽  
Emilija Bukurov-Sudjic ◽  
Zivka Uskokovic-Stefanovic ◽  
Aleksandra Dudvarski-Ilic ◽  
Mihailo Stjepanovic ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Lung Biopsy ◽  
Fiberoptic Bronchoscopy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Transbronchial Lung Biopsy ◽  
Endobronchial Ultrasound ◽  
Unknown Etiology ◽  
Transbronchial Needle Aspiration ◽  
Needle Aspiration Biopsy

Introduction. Sarcoidosis is a multisystem disease of unknown etiology characterized by the presence of non-caseating granulomas in the affected tissues and organs. In most cases, biopsy of available lesions and histological verification is required, which makes bronchoscopy a method of choice in invasive diagnostics of sarcoidosis. Due to the construction of the bronchoscope and biopsy instruments, high quality tissue samples can be obtained from different anatomic locations. Transbronchial lung biopsy. Transbronchial lung biopsy with forceps represents a standard in diagnostics of sarcoidosis and it is always performed during bronchoscopy. Sensitivity and specificity of this method are rising with the stage of disease and it is performed even if chest radiography shows no changes in lung parenchyma. Endoscopic finding in sarcoidosis and endobronchial biopsy (biopsy of bronchial mucosa). Endobronchial biopsy results in diagnosis in 70% of patients with sarcoidosis and positivity is even higher when combined with transbronchial lung biopsy (76-86%). Transbronchial needle aspiration biopsy. Transbronchial needle aspiration biopsy is a safe and widely used routine method, especially if sarcoidosis is in stages I and II. Higher positivity and better quality of biopsy samples can be achieved when transbronchial needle aspiration biopsy is guided by the endobronchial ultrasound. Bronchoalveolar lavage. The significance of bronchoalveolar lavage remains controversial and subjected to further clinical investigations. Conclusion. All presented data point out that all biopsy techniques available should be used during fiberoptic bronchoscopy under suspicion of sarcoidosis, regardless of radiographic and endoscopic appearances.

scholarly journals Role of Bronchoscopic Techniques in the Diagnosis of Thoracic Sarcoidosis

2019 ◽  
Vol 8 (9) ◽  
pp. 1327 ◽  
Author(s):  
Cecília Pedro ◽  
Natália Melo ◽  
Hélder Novais e Bastos ◽  
Adriana Magalhães ◽  
Gabriela Fernandes ◽  
...  
Keyword(s):  
Lung Biopsy ◽  
Granulomatous Inflammation ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Proper Diagnosis ◽  
Transbronchial Lung Cryobiopsy ◽  
High Level

The diagnosis of sarcoidosis relies on clinical and radiological presentation, evidence of non-caseating granulomas in histopathology and exclusion of alternative causes of granulomatous inflammation. Currently, a proper diagnosis, with a high level of confidence, is considered as key to the appropriate diagnosis and management of the disease. In this sense, this review aims to provide a brief overview on the role of bronchoscopy in the diagnosis of thoracic sarcoidosis, incorporating newer techniques to establish, including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), transesophageal ultrasound-guided needle aspiration with the use of an echo bronchoscope (EUS-B-FNA) and transbronchial lung cryobiopsy (TBLC). Most of the literature reports the diagnostic superiority of endosonographic techniques, such as EBUS-TBNA alone or in combination with EUS-FNA, over conventional bronchoscopic modalities in diagnosing Scadding stages I and II of the disease. Moreover, TBLC may be considered a useful and safe diagnostic tool for thoracic sarcoidosis, overcoming some limitations of transbronchial lung biopsy (TBLB), avoiding more invasive modalities and being complementary to endosonographic procedures such as EBUS-TBNA.

scholarly journals Amyloidosis of the respiratory system: 16 patients with amyloidosis initially diagnosed ante mortem by pulmonologists

2020 ◽  
Vol 6 (3) ◽  
pp. 00313-2019
Author(s):  
Masami Yamada ◽  
Noboru Takayanagi ◽  
Hideaki Yamakawa ◽  
Takashi Ishiguro ◽  
Tomohisa Baba ◽  
...  
Keyword(s):  
Lymph Node ◽  
Respiratory System ◽  
Lung Biopsy ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Pulmonary Amyloidosis ◽  
Tracheobronchial Amyloidosis

BackgroundAnte mortem diagnosis of amyloidosis of the respiratory system is rare. Few data are available regarding clinical presentation, precursor proteins, diagnostic procedures, comorbidities, complications, and outcome. We assessed clinical features of a series of patients with amyloidosis of the respiratory system in two Japanese centres.MethodsMedical records of 16 patients with amyloidosis of the respiratory system were retrospectively analysed. Amyloid was diagnosed by polarisation microscopy using Congo red-stained tissue specimens and classified immunohistochemically.ResultsMedian patient age was 71 years, and median follow-up period was 5 years. Immunoglobulin light-chain (AL)-λ amyloidosis was found in eight and AL-κ in five patients. Two patients harboured wild-type transthyretin and one harboured serum amyloid A-derived amyloid. Five different forms of amyloidosis of the respiratory system were observed: nodular pulmonary amyloidosis (seven patients), diffuse alveolar-septal amyloidosis (five), mediastinal lymph node amyloidosis (three), tracheobronchial amyloidosis (one), and pleural amyloidosis (one). One patient had diffuse alveolar-septal amyloidosis and mediastinal lymph node amyloidosis. Three of five patients with diffuse alveolar-septal amyloidosis were diagnosed by transbronchial lung biopsy as having concurrent diffuse alveolar haemorrhage or pneumocystis pneumonia. Two of three patients with mediastinal lymph node amyloidosis were diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration.ConclusionsNot only nodular pulmonary amyloidosis, diffuse alveolar-septal amyloidosis, and tracheobronchial amyloidosis but also mediastinal lymph node amyloidosis and pleural amyloidosis should be considered in the differential diagnosis of amyloidosis of the respiratory system. Useful diagnostic methods include transbronchial lung biopsy for diffuse alveolar-septal amyloidosis and endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal lymph node amyloidosis.

scholarly journals Sarcoidosis – moving to the new standard of diagnosis?

Medicina ◽  
2010 ◽  
Vol 46 (7) ◽  
pp. 443 ◽  
Author(s):  
Skaidrius Miliauskas ◽  
Marius Žemaitis ◽  
Raimundas Sakalauskas
Keyword(s):  
Bronchoalveolar Lavage ◽  
Endoscopic Ultrasound ◽  
Lung Biopsy ◽  
Recent Literature ◽  
Needle Aspiration ◽  
Epithelioid Cell ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Fine Needle

In this article, the most recent literature data regarding the diagnosis of sarcoidosis have been reviewed. The diagnosis of sarcoidosis can be reliably established when there is a compatible clinical/radiological picture together with pathologic evidence of noncaseating epithelioid cell granulomas. Pathologic specimens can be obtained by conventional bronchoscopy with endobronchial, transbronchial lung biopsy, bronchoalveolar lavage, and recently introduced endoscopic ultrasound techniques (endoscopic ultrasound-guided fine-needle aspiration, EUS-FNA, and endobronchial ultrasound-guided transbronchial needle aspiration, EBUS-TBNA) or surgical procedures such as thoracotomy, thoracoscopy, and mediastinoscopy. The place and value of EBUS-TBNA or EUS-FNA in diagnosis of sarcoidosis are discussed.

Acute pericarditis and mediastinal lymph node abscess developing after endobronchial ultrasound guided transbronchial needle aspiration

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Shingo Nishikawa ◽  
Ryo Ariyasu ◽  
Tomoaki Sonoda ◽  
Masafumi Saiki ◽  
Takahiro Yoshizawa ◽  
...  
Keyword(s):  
Lymph Node ◽  
Mediastinal Lymph Node ◽  
Tumor Therapy ◽  
Needle Aspiration ◽  
Lymph Node Biopsy ◽  
Endobronchial Ultrasound ◽  
Tumor Treatment ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Acute Pericarditis

A 27-year-old man was diagnosed with inflammatory myofibroblastic tumor, and multiple lymph node and subcutaneous metastases. After several administrations of anti-tumor therapy, he underwent mediastinal lymph node biopsy using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to confirm tumor relapse. Five weeks later, he complained of chest pain, then rapidly developed shock due to acute pericarditis. Although he was treated with antibiotics for anaerobic bacterial infection and cardiac drainage, mediastinal lymph node abscess and pericarditis did not improve. After the surgical procedure, his physical condition dramatically improved and he was treated with another molecularly targeted therapy. Pericarditis associated with EBUS-TBNA is extremely rare. In this case, salvage was achieved by surgical drainage of the lymph node abscess and pericarditis, and long survival was obtained with further administration of anti-tumor treatment.

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