EBUS-TBNA is less invasive and acceptably sensitive as a method for obtaining pathological confirmation of sarcoidosis.

The EBUS-TBB using a 3.4-mm thin bronchoscope and a 1.4-mm radial probe is feasible, accurate, and safe for the diagnosis of peripheral pulmonary lesions.

In the present study, the authors evaluated the diagnostic utility of a novel thin bronchoscope with a 1.7-mm working channel for peripheral pulmonary lesions.A total of 118 patients were included in this prospective study. Bronchoscopic examination was performed using a 5.9-mm standard bronchoscope. If no visible endobronchial lesion was found, transbronchial biopsies were performed with 1.5-mm biopsy forceps under fluoroscopic guidance and the bronchus were washed with 10-20 mL of saline solution, using a prototype 3.5-mm thin bronchoscope with a 1.7-mm working channel.Endobronchial lesion was visualised with the standard bronchoscope in 16 patients, and the other 102 patients underwent biopsies with the thin bronchoscope. The mean bronchus levels reached with the standard bronchoscope and the thin bronchoscope were 2.3 and 4.3 generations, respectively. Endobronchial abnormality was revealed with the thin bronchoscope in a further 14 patients. Diagnostic material was obtained in 50 of 68 (74%) patients with malignant disease and 18 of 30 (60%) patients with benign disease. Four patients did not return to follow-up. The diagnostic yield was 57%, even in lesions ,20 mm. There were no major complications.In conclusion, bronchoscopy using a 3.5-mm thin bronchoscope with a 1.7-mm working channel is useful and safe for the diagnosis of peripheral pulmonary lesions.KEYWORDS: Bronchoscopy, lung cancer, peripheral pulmonary lesions, thin bronchoscope, transbronchial biopsy, ultrathin bronchoscope L ocalised peripheral pulmonary lesions are commonly encountered in clinical practice and frequently require tissue diagnoses to project a treatment plan. In the diagnosis of such lesions, bronchoscopy under fluoroscopic guidance has come into wide use as a simple, safe and readily available sampling technique. However, the diagnostic yield of bronchoscopy for peripheral pulmonary lesions has been reported to be limited, so the usefulness of conventional bronchoscopy is controversial [1][2][3].Innovation in technology has permitted the development of some promising bronchoscopes, including those that are thinner than conventional types. A preliminary study suggested that the use of a thin bronchoscope (BF-3C40, 3.3-mm distal end diameter, 1.2-mm working channel diameter; Olympus, Tokyo, Japan) as an adjunct instrument to a standard bronchoscope increases the diagnostic yield by providing an accurate pathway to the peripheral pulmonary lesions [4]. However, transbronchial biopsy (TBB) using currently available biopsy forceps for the 1.2-mm working channel was not performed in that study; the role of the thin bronchoscope as a single method for diagnosing peripheral pulmonary lesions therefore remains unclarified. In addition, several investigators have indicated that the smallcalibre working channel (1.2 mm) of now-available thin bronchoscopes is limited by insufficient specimen collection [5][6][7]. Therefore, the clinical application of thin bronchoscopy for the examination of peripheral pulmonary lesions in adult ...

Introduction: Increased serum procalcitonin (PCT), a well-known biomarker for sepsis, has been reported in several cancer types. We aimed to investigate the prognostic impact of PCT in non-small cell lung cancer (NSCLC). Methods: Medical records of 51 consecutive patients with NSCLC (Aichi Medical University Hospital) admitted between July 2017 and July 2018 were retrospectively reviewed. The patients were divided into PCT-low (PCT < 0.1 ng/mL) and PCT-high (PCT ⩾ 0.1 ng/mL) groups, and their clinical characteristics and survival were compared. Results: In contrast to the PCT-low group (n = 24), the PCT-high group (n = 27) showed significantly worse Performance Status (PS) and overall survival (OS) (PS 0–2/3–4, 16/8 versus 12/15, p = 0.034; median OS, not reached versus 127 days, p < 0.001), irrespective of the presence of infection ( p = 0.785). Multivariate analysis showed that the disease stage (IV versus I–III) and high PCT level (⩾0.1 versus <0.1 ng/mL) were significantly worse prognostic factors with hazard ratios of 3.706 ( p = 0.023) and 3.951 ( p = 0.010), respectively. Conclusion: The results suggest that serum PCT in NSCLC was elevated regardless of the presence of infection. Higher PCT levels are associated with poor PS and shorter OS in NSCLC.

The silicone stent has been widely used to re-establish airway patency for patients with airway stenosis. The ideal shape of the stent should be well adapted to the tracheobronchial anatomic structures, and its optimal length should cover the entire inner wall of the stenotic airway. Although the silicone Y-stent was developed as a dedicated prosthesis for main carinal stenosis, we often encounter patients with tracheobronchial stenosis that cannot be treated by a single silicone Y-stent. The present study reports 2 cases of malignant disease who underwent double Y-stent placement on the involved carina between the right upper lobe bronchus and the bronchus intermedius as well as on the involved main carina as a unit. The procedure provided successful palliation.