Diagnosis of unexposed tumours using endobronchial ultrasonography with a guide sheath and a thin transbronchial needle

Abstract

Transbronchial diagnosis of unexposed lung tumours is challenging in clinical practice. Although modified transbronchial needle aspiration (TBNA) is used for this purpose, the diagnostic yield is unsatisfactory. In such cases, conventional endobronchial ultrasonography with a guide sheath and transbronchial biopsy (TBB) is also ineffective. We found TBB was feasible by placing a guide sheath with a thin transbronchial needle into the tumours. We report two cases of unexposed tumours diagnosed successfully with this technique. Case 1 presents a typical carcinoid in the peripheral lung. Case 2 presents a squamous cell carcinoma at the third bifurcation of the right lung. TBB samples obtained this way were larger than TBNA samples. Moreover, multiple TBBs were possible once the guide sheath was inserted intratumourally. In the modern era of precision medicine, larger amounts of tissues are required for multiple downstream analyses. This novel technique will make a significant contribution towards diagnosing unexposed lung tumours.

Diagnostic efficacy and safety of radial probe endobronchial ultrasound-guided transbronchial needle aspiration for adjacent lesions in segmental or subsegmental bronchi: a single-center retrospective study

“…Specifically, REBUS-TBNA has demonstrated unique advantages for lesions located in the segmental or subsegmental bronchi of the upper lobe. Furthermore, the value of guided sheath (GS)-TBNA in needle aspiration biopsy for peripheral pulmonary lesions (PPLs) located far from the central airway is gradually being recognized [ 37 – 39 ]. Looking ahead, it is foreseeable that REBUS-GS-TBNA holds great potential in the diagnosis of pulmonary lesions.…”