Lung Lessons and Bronchoscopy-Guided Biopsies Can Both be Used to Detect Pulmonary Lesions. by Dr. Kanmani MK

Pulmonary Lesions

It has always been challenging for clinicians to swiftly and accurately diagnose periphery pulmonary lesions (PPL). Although CT-guided percutaneous lung biopsy provides an excellent diagnostic yield for peripheral lesions, there are numerous risks involved, including pneumothorax and hemorrhage. Although there are fewer problems with TBLB (Trans Bronchial Lung Biopsy), there is a reduced diagnostic yield for the peripheral lesion. Up to four grade 5 bronchus can be reached with conventional bronchoscopy. The operation field can be expanded to 6-grade, 7-grade, or even more distal bronchus with the use of ultra-fine bronchoscopy, intratracheal ultrasound, and virtual navigation, which improves the accuracy of our location of pulmonary nodules. A bronchoscope and VBN have recently been utilized to diagnose peripheral lung lesions more effectively, safely, and without the need for any additional advanced procedures like radial EBUS with C-ARM. A traditional lung biopsy has a yield of 20% and can accurately identify 8% to 20% of lung abnormalities. One of the new technologies created in recent years is virtual navigation. The high-resolution chest CT picture obtained without septum scanning is directed into the virtual navigation system.

Bronchoscopy Guided

If an endobronchial mass is observed, bronchoscopy-guided biopsies may be used to diagnose pulmonary abnormalities. However, if no visible mass lesions are seen during bronchoscopy, it can be challenging to detect deep lung abnormalities. The virtual bronchoscopy navigation (VBN) technique, which uses virtual pictures to direct us to the lung lesions for greater yield, is a promising navigational bronchoscopy technique. This case report's main goal is to demonstrate the usefulness of virtual bronchoscopy navigation for deep-seated per bronchial peripheral lung lesions in terms of diagnosis.

Lung Disease 

Disorders of the lungs, the organs that allow us to breathe, are referred to as lung diseases. Lung disease-related breathing issues may limit the body's ability to get enough oxygen. Lung conditions include, for example, Emphysema, persistent bronchitis, and asthma infections such as pneumonia and the flu A lung cancer Pulmonary fibrosis with sarcoidosis (SAR-KOY-doh-sis)

Lung Cancer

After breast cancer, lung cancer is the most frequent cancer in the world. Lung nodules are being evaluated in greater numbers now that chest CT (Computer Tomography) scans are available. While CT-guided biopsy is one technique for sampling lung nodules, it is invasive and has a high rate of complications, including pneumothorax, hemorrhage, hem thorax, and on-table death. Therefore, a different technique for lung nodule or mass sampling was required that had a higher yield and fewer complications than traditional CT-guided biopsy. Focus has shifted to less invasive, more targeted methods like VBN due to the high risk of complications associated with CT-guided biopsy (Virtual Bronchoscopic Navigation). The virtual bronchoscopy navigation approach uses virtual bronchoscopy images of the bronchial route as non-invasive guidance to guide the bronchoscope to a peripheral lesion. This imaging technique creates images that resemble those seen during invasive bronchoscopy by reconstructing the airways in three dimensions using non-contrast-enhanced computed tomographic images. In the peri-broncho-vascular and subpleural sections of the bilateral lung parenchyma, there were numerous distinct patches of ground glass opacities and a few enhancing lymph nodes that were a few centimeters in size. Analyses of the biochemistry and complete blood counts were normal. The cytology of the sputum revealed no cancer cells. A flexible fiberoptic bronchoscopy (FBB) was performed on the patient in order to further evaluate the lesion. Tran's bronchial biopsy revealed uneven mucosa, but no evident mass lesion was visible at the anterior section of the right upper lobe bronchus. None of the systems that are currently available contain real-time instrument tracking during the navigation process, therefore they cannot confirm the location of the operating instrument or show the target nodule. VBN thus raises the likelihood of biopsying the target PPL (Peripheral Pulmonary Lesion). The overall diagnostic yield for peripheral pulmonary lesions using VBN was 80.4%. Despite the fact that VBN was utilized for peripheral lesions, it can help to target any lesion for a better diagnostic outcome, as it did in our case. 

Journal Information

Journal of Pulmonology, an official publication of the Pulsus group, is a peer-reviewed, open-access journal in the respiratory research fraternity facilitating real-time peer-reviewed information on the subject. 

We accept articles across the discipline but are not limited to:

Asthma, Bronchiectasis, Bronchitis, Chronic Obstructive Pulmonary Disease (COPD), Chronic Hypercapnic respiratory failure (CHRF), Emphysema, Interstitial Lung Diseases, Lung Cancer, Obstructive Sleep Apnea, Pleural Effusion, Pneumoconiosis, Pneumonia, ARDS (acute respiratory distress syndrome), Cystic Fibrosis, Solitary Pulmonary Nodule, Tuberculosis. 

*The “Journal of Pulmonology”

Publishes current research articles related to Pulmonary.

Manuscript Submission link: https://www.pulsus.com/submissions/pulmonology.html