Endobronchial ultrasound‐guided cryobiopsy for diagnosing a case of granulomatosis with polyangiitis

Abstract

EBUS‐TBNA has represented a revolution in the diagnosis of intrathoracic pathologies, particularly in lung cancer staging, replacing more invasive methods such as mediastinoscopy. However, its role in diagnosing rare benign or malignant mediastinal disorders is still a matter of debate. Over the past few years, the role of EBUS‐guided cryobiopsy has been increasingly emerging as an innovative and minimally invasive technique in diagnosing these disorders, with an excellent safety profile. In this case report, we present the case of a young man brought to our attention after already undergoing a non‐diagnostic trans thoracic needle aspiration (TTNA) procedure for lung consolidations. In our department, he underwent an initial EBUS‐TBNA procedure with inconclusive rapid on‐site evaluation (ROSE), leading to the decision to perform an EBUS‐guided cryobiopsy, which yielded a diagnosis of granulomatosis with polyangiitis without complications. This clinical case demonstrates that in specific contexts, EBUS‐cryobiopsy represents an excellent diagnostic tool.

Transbronchial lung cryobiopsy under real‐time radial EBUS: First report on a novel twist of the classical technique

“…The technique not only proven useful in the diagnostic approach of patients with interstitial lung disease (ILDs), but also in patients with pulmonary lesions of benign or malignant origin especially when combined with other modalities such as radial EBUS (rEBUS), fluoroscopy, navigation bronchoscopy, cone bean‐CT (CBCT), robots or to sample mediastinal lesions near the airways. 2 , 3 , 4 rEBUS on the other hand is the cornerstone modality used for reaching ‘invisible’ peripheral pulmonary lesions. Especially for those cases, the combination of thin or ultrathin bronchoscope, rEBUS with or without the use of guiding sheath (GS) and the use of 1.1 mm cryoprobe has been studied and proven an efficient combination for diagnosing PPLs.…”

“…The technique not only proven useful in the diagnostic approach of patients with interstitial lung disease (ILDs), but also in patients with pulmonary lesions of benign or malignant origin especially when combined with other modalities such as radial EBUS (rEBUS), fluoroscopy, navigation bronchoscopy, cone bean-CT (CBCT), robots or to sample mediastinal lesions near the airways. [2][3][4] rEBUS on the other hand is the cornerstone modality used for reaching Nektarios Anagnostopoulos and Simone Petrarulo have contributed equally to the work.…”