Diagnosis based on electromagnetic navigational bronchoscopyguided biopsied peripheral lung lesions in a 10-year-old girl:A case report

BACKGROUND Electromagnetic navigational bronchoscopy(ENB)is an emerging diagnostic tool that enables practitioners to biopsy peripheral lung tissues that were previously only accessible under computed tomography(CT)guidance.However,few studies have investigated ENB use in children.Here,we report a case of a 10-yearold girl with peripheral lung lesions who complained of a 7-d persistent fever.She was diagnosed with Streptococcus parasanguinis infection based on findings obtained using ENB-guided transbronchial lung biopsy(TBLB).CASE SUMMARY A 10-year-old girl presented with constitutional symptoms of cough and fever of 7 days’duration.Chest CT scans detected peripheral lung lesions and no endobronchial lesions.TBLB performed under the guidance of an ENB Lungpro navigation system was safe,well-tolerated,and effective for biopsying peripheral lung lesions.Examination of biopsied samples indicated the patient had a pulmonary Streptococcus parasanguinis infection,which was treated with antibiotics instead of more invasive treatment interventions.The patient’s symptoms resolved after she received a 3-wk course of oral linezolid.Comparisons of pretreatment and post-treatment CT scans revealed absorption of some lung lesions within 7 mo of hospital discharge.CONCLUSION ENB-guided TBLB biopsying of peripheral lung lesions in this child is a safe,well-tolerated,and effective alternative to conventional interventions.

Value of virtual bronchoscopic navigation and transbronchial ultrasound-guided sheath-guided exploration in diagnosis of peripheral lung cancer

BACKGROUND Peripheral lung cancer poses a substantial harm to human health,and it is easy to become exacerbated,potentially threatening the life and safety of patients AIM To assess the value of virtual bronchoscopic navigation(VBN)combined with transbronchial ultrasound-guided sheath-guided(EBUS-GS)exploration in the diagnosis of peripheral lung cancer.METHODS A total of 236 patients with peripheral lung cancer(nodule diameter range,8-30 mm;diagnosed using high-resolution computed tomography)were selected from three centers between October 2018 and December 2019.Patients who underwent EBUS-GS exploration alone were included in a control group,and those who received VBN in combination with EBUS-GS exploration were included in an observation group.The diagnostic rate and total operating time of differentsubgroups of the two groups were compared,and the time needed to determine the lesion was recorded.RESULTS There were no significant differences in diagnosis rate or total operation time between the two groups(P>0.05),and the time needed to determine the lesion in the observation group was less than that of the control group(P<0.05).CONCLUSION The combined use of VBN and EBUS-GS exploration technology has little effect on the diagnosis rate and total operation time of peripheral lung cancer,but it significantly shortens the time needed to determine the lesion and is a valuable diagnostic method.

Evolution of transbronchial needle aspiration needles: Over the last half century

Transbronchial needle aspiration(TBNA)is a commonly used sampling approach in the diagnosis of hilar and mediastinal lymphadenopathy as well as peripheral lesions.As a very important tool,the continued innovation of TBNA needles is a vital driving force for the development of the technique.Although TBNA plays an important role in interventional pulmonology,there are no clear standards guiding operators to choose an appropriate needle for their operation.In recent decades,with the advent of endobronchial ultrasound-guided TBNA(EBUS-TBNA),the real-time visualization of TBNA has been enabled.These modern TBNA needles,such as ViziShot2,FLEX 19G,Acquire FNB,and EchoTip ProCore,have made significant progress in specimen collection,convenience,and safety,though still remain grounded in the basic premise and initial upgrades to the original conventional TBNA(cTBNA)needles.This review introduced the developmental history of WANG cTBNA needles,and summarized the lessons of success and failure and the enlightenments for currently used EBUS-and other emerging TBNA needles,aiming to provide a significant reference for pulmonologists who lived through the cTBNA era and for junior physicians who start working in the EBUS-TBNA era.Despite its long history,TBNA is still playing significant roles in the diagnosis of pulmonary diseases.A deeper understanding from the historical perspectives would facilitate continued innovations in the field of TBNA and beyond.