Journal of bronchology & interventional pulmonology
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J Bronchology Interv Pulmonol · Jan 2012
Review Case ReportsBilateral pneumothorax after bronchoscopy without biopsy--a rare complication: case presentation and literature review.
Bronchoscopy and bronchoalveolar lavage (BAL) are widely accepted diagnostic procedures in various pulmonary etiologies. Complications of bronchoscopy are relatively infrequent and most often minor, namely, bleeding and infection. Pneumothorax is a rare complication of bronchoscopy with transbronchial biopsy. ⋯ The pneumothorax was resolved with the chest tube and the patient recovered. However, the etiology of the pneumothorax remained unclear. We presume that cough-related increase in intrathoracic pressure might have led to interstitial air dissection and bilateral pneumothorax.
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J Bronchology Interv Pulmonol · Jan 2012
Randomized Controlled TrialCytologic assessment of endobronchial ultrasound-guided transbronchial needle aspirates in sarcoidosis.
The purpose of this study was to determine interobserver variability, the relative importance of cytologic preparations, and factors influencing the diagnostic yield of mediastinal lymph node aspirates in suspected sarcoidosis. ⋯ Liquid-based cytology and cell block specimens are equally important in maximizing the diagnostic yield in EBUS-guided and conventional TBNA in suspected sarcoidosis. Good interobserver agreement between cytopathologists was noted, with improved diagnostic yield after review by a pulmonary cytopathologist. None of the clinical factors assessed impacted on the diagnostic yield of the procedure on a per-node basis.
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J Bronchology Interv Pulmonol · Jan 2012
Case ReportsLingual nerve paralysis after endobronchial ultrasound utilizing laryngeal mask airway.
A 52-year-old woman developed loss of sensation and taste in the anterior two thirds of her tongue after undergoing endobronchial ultrasound-guided transbronchial needle aspiration using a laryngeal mask airway (LMA). This was believed to be due to bilateral lingual nerve injury, likely caused by stretching of tissue of the upper airway because of repetitive movements of LMA during attempts to obtain a clearer ultrasound image to direct needle insertion. To the best of our knowledge, this is the first report of lingual nerve injury after an endobronchial ultrasound procedure using LMA.
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J Bronchology Interv Pulmonol · Jan 2012
Comparative StudyExtraction of tracheobronchial foreign bodies in children and adults with rigid and flexible bronchoscopy.
Tracheobronchial foreign bodies (TBFBs) due to accidental aspiration are seen in both children and adults and are usually extracted by flexible bronchoscopy (FB) or rigid bronchoscopy (RB). The experience over a decade of treating 214 patients with TBFBs has been analyzed retrospectively. ⋯ From our experience of extraction of TBFBs over more than a decade, we have drawn the following conclusions: (1) TBFBs present most frequently in the age group of 1 to 2 years, with cough and/or breathlessness commonly following a choking episode; (2) a high index of suspicion is essential and diagnostic FB should be performed in all such cases even though the chest radiograph is normal; (3) TBFBs can be life threatening and may require to be treated as an emergency; (4) FB may be used first for diagnosis and extraction under conscious sedation for nonasphyxiating TBFBs. It is usually more successful in adults and less so in children; (5) in these patients, if FB is unsuccessful, then RB may be used to extract the TBFB; (6) for asphyxiating TBFBs, RB is the procedure of choice; (7) pulmonologists who wish to practice extraction of TBFBs ought to be trained in both FB and RB and must possess adequate equipment and a skilled team to assist them.
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J Bronchology Interv Pulmonol · Jan 2012
Case ReportsA 77-year-old man with progressive dyspnea, lung fibrosis, and ossification.
: Diffuse pulmonary ossification is a rare clinical entity in which mature bone formation occurs within the pulmonary tissues. It has been associated with multiple pulmonary and systemic conditions and may be an indicator of disease severity and chronicity. It is often diagnosed only post mortem, because of its variable presentation with either very significant findings, mimicking other serious conditions, or very subtle onset unrecognized on imaging. In this report, we present the clinical presentation and findings in a case of diffuse pulmonary ossification diagnosed by transbronchial biopsy in a living patient.