Advances in interventional diagnostic bronchoscopy for peripheral pulmonary lesions.

This article reviews the clinical evidence of recent emerging interventional bronchoscopic techniques for diagnosis of PPLs. Expert opinion: Recent advances in interventional bronchoscopy contribute to not only the safety of transbronchial approaches to PPLs but also the higher diagnostic yield. To perform accurate sampling of PPLs, bronchoscopists must select the correct airway, approach the target as close as possible, and confirm the location of the target before sampling. These key steps can be assisted by recently developed technologies. However, it is important for bronchoscopists to understand the strengths and limitations of these emerging technologies. PMID: 31322455 [PubMed - as supplied by publisher]
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

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Conclusion Diagnostic procedures should be chosen based on the clinical character in EBUS-TBNA negative patients with suspected lung cancer. Long time follow-up is very important in patients whose diagnosis is apparently unknown. 
 DOI: 10.3779/j.issn.1009-3419.2019.04.04
Source: Chinese Journal of Lung Cancer - Category: Cancer & Oncology Source Type: research
Programmed death ligand 1 (PD-L1) immunohistochemistry (IHC) assays are widely used for complementary or companion diagnostic purposes during treatment with immune checkpoint inhibitors. However, limited information is available on the clinical reliability of the PD-L1 IHC assay using small biopsy samples. Participants included 46 patients with nonsmall cell lung cancer who underwent PD-L1 testing using 3 PD-L1 IHC assays (22C3, SP142, and SP263) for both small biopsy samples and surgical specimens from November 2017 to June 2018. The PD-L1 IHC assay results were analyzed with cut-off values of 1%, 5%, 10%, and 50%. The P...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Valliappan Muthu, Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy T Prasad, Nalini Gupta, Ashutosh N Aggarwal, Ritesh AgarwalJournal of Cytology 2019 36(1):65-70 Intrathoracic lymphadenopathy is a common problem encountered in clinical practice and is caused by a wide variety of diseases. Traditionally, the mediastinal lymph nodes were sampled using conventional transbronchial needle aspiration (TBNA), or surgical methods such as mediastinoscopy, and thoracotomy (open or video-assisted thoracoscopy). However, surgical modalities including mediastinoscopy are invasive, expensive, and not universally available. Moreover,...
Source: Journal of Cytology - Category: Cytology Authors: Source Type: research
Lung cancer-related deaths in the United States in 2015 totaled 153,718, which is equivalent to a major catastrophe such as a Boeing 777 aircraft crashing and killing 550 passengers every 1.5 days per year. Lung cancer is the third most common cancer after breast cancer (for women) and prostate cancer (for men). In 2015, there were 218,527 new cases of lung cancer diagnosed in the United States. The large incidence and mortality of this malignancy makes it essential for efficient, accurate, and timely diagnosis via minimally invasive methods for lung cancer as well as staging. It is, therefore, of utmost importance to adeq...
Source: Clinical Pulmonary Medicine - Category: Respiratory Medicine Tags: Clinical Myths And Evidence-based Medicine Source Type: research
Conclusion: This study highlights the major place taken by bronchoscopy, in particular new guidance techniques, for the diagnosis of lung cancer in an expert center
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung Cancer Source Type: research
Background: A sufficient amount of tissue is required for the evaluation of tumor programmed death-ligand 1 (PD-L1) expression. However, in many cases, we must test PD-L1 expression using small tissues by bronchoscopy.Objection: We analyzed the usefulness of transbronchial biopsy (TBB) to test PD-L1 expression in lung cancer tissue.Methods: Expression of PD-L1 was assessed in tumor specimens by using an automated immunohistochemical assay (PD-L1 IHC 22C3 pharmDx; Dako) for 55 TBB specimens and 22 surgical specimens at Hokkaido University Hospital. Evaluation of PD-L1 expression was as follows; No = tumor proportion score (TPS)
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung Cancer Source Type: research
Endoscopic ultrasound (with bronchoscope) fine needle aspiration (EUS-B-FNA) has been recognized as a useful and safe technique in sampling mediastinal lymph nodes. Few data are available on its accuracy in diagnosing pulmonary parenchymal lesions adjacent to the esophagus.We performed an observational, retrospective study aimed to evaluate accuracy and safety of EUS-B-FNA for lung parenchymal abnormalities, in two Italian reference centers. Furthermore, impact of rapid on-site evaluation (ROSE) and lesion anatomical site (i.e. lobe) on diagnostic yield were assessed.From November 2016 to January 2018, 21 patients (52.4% m...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
Transesophageal ultrasound with the EBUS-bronchoscope (EUS-B) facilitates together with EBUS the staging of lung cancer. Whether EUS-B is feasible for the left adrenal gland (LAG) has not been prospectively evaluated.We run a prospective study with all patients that received EBUS from march-august 2017: Group A with a suspected or history of malignancy; group B without suspicion of malignancy and thoracic lymph nodes.In group A EUS-B-fine needle aspiration (FNA) was performed, if (PET)-CT or EUS-B were suspicious. 4 bronchoscopists (>500 EBUS-procedures) participated.LAG was proven malignant in the following conditions ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
Conclusion: The visual appearance of EBUS-TBNA aspirate may provide a clue to the diagnosis. This may prompt the bronchoscopist to obtain samples for ancillary investigations such as Xpert MTB/RIF in cheesy aspirates and avoid further passes from ‘black’ nodes during lung cancer staging.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
Conclusions: All-cause 7-day mortality was inversely associated with HV. The risk of DB in patients with lung cancer should be recognized, and the exploitation of EBUS may help reduce mortality after DB.Respiration
Source: Respiration - Category: Respiratory Medicine Source Type: research
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