Manu Madan, Sreyas Sharma, Rohit Kumar, P. Ish, Rajnish Kaushik, Nitesh Gupta
Airway stents are critical in maintaining airway patency and managing Central Airway Obstruction (CAO) caused by malignant and benign conditions. Despite their effectiveness, complications such as stent migration are common. We report a case of a 25-year-old female with malignant CAO, which was initially managed with an ultra-flex Self-Expanding Metal Stent (SEMS) followed by stent migration and subsequently interlocking SEMS with Y stent deployment. This case report highlights the complexity of managing malignant CAO. More research is needed to establish optimal practices for preventing stent migration and improving patient outcomes. A systematic review of the literature on airway stent migration was also conducted, revealing an incidence of 5-17%, with higher rates in tracheal stents. Factors such as lesion characteristics and location significantly impact migration risk. This review discusses the advantages and challenges of SEMS compared to silicone stents, emphasizing the need for tailored approaches in stent placement and fixation to mitigate migration risks.
气道支架对于保持气道通畅和处理恶性和良性疾病引起的中央气道阻塞（CAO）至关重要。尽管支架效果显著，但支架移位等并发症也很常见。我们报告了一例 25 岁女性恶性 CAO 患者的病例，患者最初使用超柔性自膨胀金属支架（SEMS）进行治疗，但支架发生了移位，随后使用 Y 型支架联锁 SEMS。该病例报告凸显了恶性 CAO 治疗的复杂性。需要开展更多研究，以确定防止支架移位和改善患者预后的最佳方法。我们还对有关气道支架移位的文献进行了系统性回顾，发现其发生率为 5-17%，气管支架的发生率更高。病变特征和位置等因素对移位风险有重大影响。本综述讨论了 SEMS 与硅胶支架相比所具有的优势和面临的挑战，强调了在支架置入和固定方面采用定制方法以降低移位风险的必要性。
{"title":"Tracheal stent migration in malignant central airway obstruction – a case report and systematic review of literature","authors":"Manu Madan, Sreyas Sharma, Rohit Kumar, P. Ish, Rajnish Kaushik, Nitesh Gupta","doi":"10.4081/cdr.12.12731","DOIUrl":"https://doi.org/10.4081/cdr.12.12731","url":null,"abstract":"Airway stents are critical in maintaining airway patency and managing Central Airway Obstruction (CAO) caused by malignant and benign conditions. Despite their effectiveness, complications such as stent migration are common. We report a case of a 25-year-old female with malignant CAO, which was initially managed with an ultra-flex Self-Expanding Metal Stent (SEMS) followed by stent migration and subsequently interlocking SEMS with Y stent deployment. This case report highlights the complexity of managing malignant CAO. More research is needed to establish optimal practices for preventing stent migration and improving patient outcomes. A systematic review of the literature on airway stent migration was also conducted, revealing an incidence of 5-17%, with higher rates in tracheal stents. Factors such as lesion characteristics and location significantly impact migration risk. This review discusses the advantages and challenges of SEMS compared to silicone stents, emphasizing the need for tailored approaches in stent placement and fixation to mitigate migration risks.","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":" 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141827238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Coronavirus Disease 2019 (COVID-19) pandemic has unveiled diverse immunological complications extending beyond the acute phase of infection. We present a case series of four patients who developed autoimmune vasculitis and sarcoidosis post-recovery from COVID-19. Case presentations include recurrent fever and respiratory symptoms in a 36-year-old female, granulomatous liver lesions in a 63-year-old male, progressive dyspnea in a 44-year-old female, and diffuse alveolar hemorrhage in a 74-year-old female following severe pneumonia. These cases underscore the importance of vigilance for immunological sequelae in post-COVID-19 patients, particularly those with predisposing comorbidities. We tried to elucidate pathophysiological mechanisms and optimize management strategies for these rare but clinically significant manifestations.
{"title":"Emerging immunological challenges in post-COVID individuals: insights from a case series and review","authors":"Saurabh Karmakar, Priya Sharma","doi":"10.4081/cdr.12.12659","DOIUrl":"https://doi.org/10.4081/cdr.12.12659","url":null,"abstract":"The Coronavirus Disease 2019 (COVID-19) pandemic has unveiled diverse immunological complications extending beyond the acute phase of infection. We present a case series of four patients who developed autoimmune vasculitis and sarcoidosis post-recovery from COVID-19. Case presentations include recurrent fever and respiratory symptoms in a 36-year-old female, granulomatous liver lesions in a 63-year-old male, progressive dyspnea in a 44-year-old female, and diffuse alveolar hemorrhage in a 74-year-old female following severe pneumonia. These cases underscore the importance of vigilance for immunological sequelae in post-COVID-19 patients, particularly those with predisposing comorbidities. We tried to elucidate pathophysiological mechanisms and optimize management strategies for these rare but clinically significant manifestations.","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":" 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obstructive Sleep Apnea (OSA) and smoking are important global health issues that are widely prevalent. Both are independently associated with cardiovascular, respiratory, metabolic, neurological, psychiatric, and endocrinological abnormalities and cancer, leading to premature death. Whether coexistent OSA and smoking worsen multisystem abnormalities is inconclusive. Therefore, this study was done to find the association between OSA and other morbidities among smokers and non-smokers. The objectives of this study were i) to evaluate the association of OSA with co-morbidities in smokers and non-smokers and ii) to compare the severity of OSA in smokers and non-smokers.
阻塞性睡眠呼吸暂停（OSA）和吸烟是全球普遍存在的重要健康问题。两者都与心血管、呼吸、新陈代谢、神经、精神和内分泌异常以及癌症有关，并导致过早死亡。同时存在的 OSA 和吸烟是否会加重多系统异常尚无定论。因此，本研究旨在找出吸烟者和非吸烟者中 OSA 与其他疾病之间的关联。本研究的目的是：i）评估吸烟者和非吸烟者的 OSA 与并发症的关系；ii）比较吸烟者和非吸烟者 OSA 的严重程度。
{"title":"Association of Obstructive Sleep Apnea with co-morbidities in smokers versus non-smokers - an observational study","authors":"A. Haran, S. Mamatha, S. Ashwini","doi":"10.4081/cdr.12.12472","DOIUrl":"https://doi.org/10.4081/cdr.12.12472","url":null,"abstract":"Obstructive Sleep Apnea (OSA) and smoking are important global health issues that are widely prevalent. Both are independently associated with cardiovascular, respiratory, metabolic, neurological, psychiatric, and endocrinological abnormalities and cancer, leading to premature death. Whether coexistent OSA and smoking worsen multisystem abnormalities is inconclusive. Therefore, this study was done to find the association between OSA and other morbidities among smokers and non-smokers. The objectives of this study were i) to evaluate the association of OSA with co-morbidities in smokers and non-smokers and ii) to compare the severity of OSA in smokers and non-smokers.","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Gogia, Shriram S. Shenoy, Tarun Bhatnagar, Shruti Nautiyal, Sunil Lakha
Like many other foodborne parasites, lung fluke (Paragonimus species) was considered extinct and is now reemerging, especially in Eastern Asia, Africa, and South America. It commonly affects people consuming crabs and crayfish in their diet. This family of seafood and mollusks is considered an intermediate host for the parasite. Humans and other mammals, such as tigers and pigs incidentally consuming crustaceans, are the definitive hosts. Here, we present a case of pulmonary paragonimiasis in a strict vegetarian who developed the infestation, the possible cause being frequent baths in the holy river Ganges, a common practice amongst Hindus. Another interesting aspect of this case is that the patient presented with signs and symptoms mimicking tuberculosis, which is also endemic in the region. Presenting symptoms of hemoptysis, generalized malaise, and a normal chest X-ray were misleading, while Flexible Bronchoscopy (FB) with Bronchoalveolar Lavage (BAL) confirmed the diagnosis. The patient made a full recovery with appropriate treatment.
与许多其他食源性寄生虫一样，肺吸虫（Paragonimus 种）曾被认为已经灭绝，但现在又重新出现，尤其是在东亚、非洲和南美洲。这种寄生虫通常影响在饮食中食用螃蟹和小龙虾的人。这一类海产品和软体动物被认为是寄生虫的中间宿主。人类和其他哺乳动物，如老虎和偶然食用甲壳类动物的猪，则是最终宿主。在这里，我们介绍了一例严格素食者患肺部副疟原虫病的病例，病因可能是印度教徒经常在圣河恒河中洗澡。本病例的另一个有趣之处在于，患者出现了类似肺结核的症状和体征，而肺结核也是该地区的地方病。咯血、全身乏力的症状和正常的胸部 X 光片都会误导患者，而灵活支气管镜（FB）和支气管肺泡灌洗液（BAL）确诊了患者。经过适当治疗，患者完全康复。
{"title":"The holy fluke - an unusual scenario of lung paragonimiasis","authors":"P. Gogia, Shriram S. Shenoy, Tarun Bhatnagar, Shruti Nautiyal, Sunil Lakha","doi":"10.4081/cdr.12.12418","DOIUrl":"https://doi.org/10.4081/cdr.12.12418","url":null,"abstract":"Like many other foodborne parasites, lung fluke (Paragonimus species) was considered extinct and is now reemerging, especially in Eastern Asia, Africa, and South America. It commonly affects people consuming crabs and crayfish in their diet. This family of seafood and mollusks is considered an intermediate host for the parasite. Humans and other mammals, such as tigers and pigs incidentally consuming crustaceans, are the definitive hosts. Here, we present a case of pulmonary paragonimiasis in a strict vegetarian who developed the infestation, the possible cause being frequent baths in the holy river Ganges, a common practice amongst Hindus. Another interesting aspect of this case is that the patient presented with signs and symptoms mimicking tuberculosis, which is also endemic in the region. Presenting symptoms of hemoptysis, generalized malaise, and a normal chest X-ray were misleading, while Flexible Bronchoscopy (FB) with Bronchoalveolar Lavage (BAL) confirmed the diagnosis. The patient made a full recovery with appropriate treatment.","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":"9 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141653548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Spalgais, Ahmed Safwan M., P. Mrigpuri, Raj Kumar
The Adverse Drug Reactions (ADRSs) to Anti-Tubercular Therapy (ATT) have been reported from 8% to 85% worldwide, while the prevalence of ADRSs to 1st line ATT from India reported 2.3% to 17%, with more during the intensive phase and daily regime. However, cutaneous ADRSs related to ATT are less commonly seen. Common cutaneous ADRSs are maculopapular rash, urticarial, erythema multiforme, exfoliative dermatitis, and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Among the 1st line ATT, pyrazinamide is the most common cause at 2.38%, and isoniazid is reported the least at 0.98%. Exfoliated dermatitis is rarely seen with 1st line ATT therapy limited to some case reports and case series.
据报道，全球抗结核疗法（ATT）的药物不良反应（ADRSs）发生率为 8%至 85%，而印度报道的一线 ATT 药物不良反应发生率为 2.3%至 17%，其中强化阶段和每日治疗期间的发生率更高。然而，与 ATT 相关的皮肤 ADRS 并不常见。常见的皮肤 ADRS 包括斑丘疹、荨麻疹、多形性红斑、剥脱性皮炎和伴有嗜酸性粒细胞增多和全身症状的药物反应（DRESS）。在一线抗逆转录病毒药物中，吡嗪酰胺是最常见的致病原因，占 2.38%，异烟肼最少，占 0.98%。剥脱性皮炎在一线 ATT 治疗中很少见，仅限于一些病例报告和病例系列。
{"title":"Exfoliated dermatitis and hepatitis to first line Anti-Tubercular Therapy with treatment of Drug-Sensitive Tuberculosis with second line Anti-Tubercular Therapy: a roller coaster ride","authors":"S. Spalgais, Ahmed Safwan M., P. Mrigpuri, Raj Kumar","doi":"10.4081/cdr.12.12626","DOIUrl":"https://doi.org/10.4081/cdr.12.12626","url":null,"abstract":"The Adverse Drug Reactions (ADRSs) to Anti-Tubercular Therapy (ATT) have been reported from 8% to 85% worldwide, while the prevalence of ADRSs to 1st line ATT from India reported 2.3% to 17%, with more during the intensive phase and daily regime. However, cutaneous ADRSs related to ATT are less commonly seen. Common cutaneous ADRSs are maculopapular rash, urticarial, erythema multiforme, exfoliative dermatitis, and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Among the 1st line ATT, pyrazinamide is the most common cause at 2.38%, and isoniazid is reported the least at 0.98%. Exfoliated dermatitis is rarely seen with 1st line ATT therapy limited to some case reports and case series.","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141271406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Retropharyngeal abscess, the infection of deep neck spaces, extends from the base of the skull to the posterior mediastinum. It develops as a sequela of dental infection, upper respiratory tract infection, or any interventional procedure like laryngoscopy, endotracheal intubation, etc. Retropharyngeal abscess is a rare presentation of Tuberculosis (TB), with an annual incidence rate of 2.64 per 100,000 population, and gender-based incidence rates of 3.34 for males, and 1.94 for females per 100,000 population.1 It, as a part of head and neck TB, has a prevalence of 0.1-1% among all forms of TB. If not managed timely, it may lead to the spread of its infection to the mediastinum, which can be life-threatening at times, owing to airway compromission and other catastrophic complications like mediastinitis, mediastinal abscess, pericarditis, pyopneumothorax pleuritis and empyema. We hereby present a case of a middle-aged woman diagnosed with a complicated retropharyngeal abscess but managed conservatively with Antitubercular Therapy (ATT).
{"title":"Conservative management of complicated retropharyngeal abscess with Antitubercular Therapy","authors":"Sakshi Boora, Komaldeep Kaur, Mandeep Kaur Sodhi, Chahat Bhatia, Diksha Attri, Varinder Saini","doi":"10.4081/cdr.12.12536","DOIUrl":"https://doi.org/10.4081/cdr.12.12536","url":null,"abstract":"Retropharyngeal abscess, the infection of deep neck spaces, extends from the base of the skull to the posterior mediastinum. It develops as a sequela of dental infection, upper respiratory tract infection, or any interventional procedure like laryngoscopy, endotracheal intubation, etc. Retropharyngeal abscess is a rare presentation of Tuberculosis (TB), with an annual incidence rate of 2.64 per 100,000 population, and gender-based incidence rates of 3.34 for males, and 1.94 for females per 100,000 population.1 It, as a part of head and neck TB, has a prevalence of 0.1-1% among all forms of TB. If not managed timely, it may lead to the spread of its infection to the mediastinum, which can be life-threatening at times, owing to airway compromission and other catastrophic complications like mediastinitis, mediastinal abscess, pericarditis, pyopneumothorax pleuritis and empyema. We hereby present a case of a middle-aged woman diagnosed with a complicated retropharyngeal abscess but managed conservatively with Antitubercular Therapy (ATT).","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":" 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141000998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sanchit Mohan, Rohit Kumar, Manu Madan, P. Ish, Rajnish Kaushik, Nitesh Gupta
Intra-pleural foreign bodies occur due to thoracic trauma or iatrogenic. Extraction of an intra-pleural foreign body is done either by thoracotomy or Video-Assisted Thoracoscopic Surgery (VATS). A 58-year-old woman presented with a right pleural effusion. Ultrasonography (USG)-guided right pleural fluid aspiration complicated as the needle broke down in the pleural cavity. Computed Tomography (CT) of the thorax documented the needle in the muscular plain between intercostal muscles and the pointing edge in the pleural cavity. A surgical exploration of the muscular plane to retrieve the needle was unsuccessful. The needle was successfully extracted by semi-rigid thoracoscopy under local anesthesia without any complications.
{"title":"A case report of an intra-pleural foreign body successfully retrieved by semi-rigid thoracoscopy and systematic review of worldwide literature","authors":"Sanchit Mohan, Rohit Kumar, Manu Madan, P. Ish, Rajnish Kaushik, Nitesh Gupta","doi":"10.4081/cdr.12.12599","DOIUrl":"https://doi.org/10.4081/cdr.12.12599","url":null,"abstract":"Intra-pleural foreign bodies occur due to thoracic trauma or iatrogenic. Extraction of an intra-pleural foreign body is done either by thoracotomy or Video-Assisted Thoracoscopic Surgery (VATS). A 58-year-old woman presented with a right pleural effusion. Ultrasonography (USG)-guided right pleural fluid aspiration complicated as the needle broke down in the pleural cavity. Computed Tomography (CT) of the thorax documented the needle in the muscular plain between intercostal muscles and the pointing edge in the pleural cavity. A surgical exploration of the muscular plane to retrieve the needle was unsuccessful. The needle was successfully extracted by semi-rigid thoracoscopy under local anesthesia without any complications.","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":"16 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141001501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nitesh Gupta, Stuti Gupta, Yash Kedia, Rohit Kumar, Mahendran Aj, P. Ish, Manu Madan, Rajnish Kaushik
Intracardiac masses on echocardiography can represent thrombi, vegetations, or tumors. Cardiac Magnetic Resonance Imaging (MRI) is a sensitive tool that differentiates between the three. Intracardiac thrombi can develop during various pathological conditions that cause stasis of blood and predispose to the aggregation of thrombotic material. Atrial clots can occur in conditions like atrial fibrillation, structural heart diseases, thrombophilia, and chronic inflammations. Tuberculosis (TB) is a prothrombotic state and can predispose to venous and sometimes arterial clot formation. But intracardiac clots in TB are rare. We report a young patient presenting with bilateral intracardiac clots and diagnosed to have disseminated tuberculosis. Treatment with anti-tubercular therapy and therapeutic anticoagulation leads to complete resolution of the thrombi.
{"title":"A 31-year-old female with diffuse pulmonary infiltrates and intracardiac thrombus","authors":"Nitesh Gupta, Stuti Gupta, Yash Kedia, Rohit Kumar, Mahendran Aj, P. Ish, Manu Madan, Rajnish Kaushik","doi":"10.4081/cdr.12.12581","DOIUrl":"https://doi.org/10.4081/cdr.12.12581","url":null,"abstract":"Intracardiac masses on echocardiography can represent thrombi, vegetations, or tumors. Cardiac Magnetic Resonance Imaging (MRI) is a sensitive tool that differentiates between the three. Intracardiac thrombi can develop during various pathological conditions that cause stasis of blood and predispose to the aggregation of thrombotic material. Atrial clots can occur in conditions like atrial fibrillation, structural heart diseases, thrombophilia, and chronic inflammations. Tuberculosis (TB) is a prothrombotic state and can predispose to venous and sometimes arterial clot formation. But intracardiac clots in TB are rare. We report a young patient presenting with bilateral intracardiac clots and diagnosed to have disseminated tuberculosis. Treatment with anti-tubercular therapy and therapeutic anticoagulation leads to complete resolution of the thrombi.","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":"28 s84","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141003562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sanchit Mohan, A. Mahendran, Rohit Kumar, Manu Madan, P. Ish, Rajnish Kaushik, Nitesh Gupta
Tissue diagnosis of mass lesions in the mediastinum poses a challenge, particularly when the mass is not in direct contact with the chest wall, rendering techniques such as Ultrasonography (USG) or Computed Tomography (CT) guided biopsies ineffective. In cases of Critical Airway Obstruction (CAO), utilizing routine endobronchial ultrasound-guided biopsies can lead to complications, including respiratory failure. As an alternative technique, Transesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) is utilized. However, when smears yield inconclusive results for histopathological diagnosis, mediastinoscopy remains the preferred modality. We present two cases of CAO where Transesophageal Bronchoscopic Ultrasound (EUS-B)-guided cryobiopsy was performed, eliminating the necessity for mediastinoscopy. Histopathological examination of the cryobiopsy samples revealed squamous cell carcinoma and small cell carcinoma. A detailed systematic review only revealed two similar studies in the past. Thus, EUS-B-guided cryobiopsy emerges as a novel technique with the potential to diagnose lesions located in the concealed regions of the mediastinum.
纵隔内肿块病变的组织诊断是一项挑战，尤其是当肿块与胸壁没有直接接触时，超声波（USG）或计算机断层扫描（CT）引导下的活组织检查等技术就会失效。在严重气道阻塞（CAO）的病例中，使用常规支气管内超声引导活检可能会导致包括呼吸衰竭在内的并发症。经食道支气管镜超声引导细针抽吸术（EUS-FNA）是一种替代技术。然而，当涂片无法得出组织病理学诊断结果时，纵隔镜检查仍是首选方式。我们介绍了两例在经食道支气管镜超声（EUS-B）引导下进行冷冻活组织检查的 CAO 病例，这些病例无需进行纵隔镜检查。冷冻活检样本的组织病理学检查显示为鳞状细胞癌和小细胞癌。在详细的系统回顾中，只发现过去有两项类似的研究。因此，EUS-B引导下冷冻生物切片检查是一种新型技术，有望诊断位于纵隔隐蔽部位的病变。
{"title":"Transesophageal Bronchoscopic Ultrasound-guided Cryobiopsy (EUS-B-Cryo) for mediastinal lesions in critical airway obstruction: a case series with a systematic review","authors":"Sanchit Mohan, A. Mahendran, Rohit Kumar, Manu Madan, P. Ish, Rajnish Kaushik, Nitesh Gupta","doi":"10.4081/cdr.12.12555","DOIUrl":"https://doi.org/10.4081/cdr.12.12555","url":null,"abstract":"Tissue diagnosis of mass lesions in the mediastinum poses a challenge, particularly when the mass is not in direct contact with the chest wall, rendering techniques such as Ultrasonography (USG) or Computed Tomography (CT) guided biopsies ineffective. In cases of Critical Airway Obstruction (CAO), utilizing routine endobronchial ultrasound-guided biopsies can lead to complications, including respiratory failure. As an alternative technique, Transesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) is utilized. However, when smears yield inconclusive results for histopathological diagnosis, mediastinoscopy remains the preferred modality. We present two cases of CAO where Transesophageal Bronchoscopic Ultrasound (EUS-B)-guided cryobiopsy was performed, eliminating the necessity for mediastinoscopy. Histopathological examination of the cryobiopsy samples revealed squamous cell carcinoma and small cell carcinoma. A detailed systematic review only revealed two similar studies in the past. Thus, EUS-B-guided cryobiopsy emerges as a novel technique with the potential to diagnose lesions located in the concealed regions of the mediastinum.","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":"39 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141009353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Sivaselvi, Akshaya Moorthy, Dharm Praksh Dwivedi, B. Badhe
Cavitary lung nodules are produced by a variety of diseases ranging from benign to malignant disease. According to the Fleischner Society, the pulmonary cavity is characterized by a gas-filled space, seen as a lucency or low-attenuation area, within pulmonary consolidation, a mass, or a nodule. Though the number and thickness of the wall of the cavity may help to differentiate causes, arriving at a diagnosis is challenging. Even though radiological findings will help to differentiate benign from malignant etiology, histopathology is needed for confirmation of diagnosis. Here, we describe a metastatic lung adenocarcinoma case presenting as multiple cavitary nodules.
{"title":"Lung adenocarcinoma - a diagnostic challenge","authors":"C. Sivaselvi, Akshaya Moorthy, Dharm Praksh Dwivedi, B. Badhe","doi":"10.4081/cdr.12.12032","DOIUrl":"https://doi.org/10.4081/cdr.12.12032","url":null,"abstract":"Cavitary lung nodules are produced by a variety of diseases ranging from benign to malignant disease. According to the Fleischner Society, the pulmonary cavity is characterized by a gas-filled space, seen as a lucency or low-attenuation area, within pulmonary consolidation, a mass, or a nodule. Though the number and thickness of the wall of the cavity may help to differentiate causes, arriving at a diagnosis is challenging. Even though radiological findings will help to differentiate benign from malignant etiology, histopathology is needed for confirmation of diagnosis. Here, we describe a metastatic lung adenocarcinoma case presenting as multiple cavitary nodules.","PeriodicalId":500149,"journal":{"name":"Chest disease reports","volume":"57 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141008870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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