The contribution of widely used devices in the diagnosis of peripheral pulmonary lesions in patients presenting with respiratory distress

• Published in: Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society Vol. 47; no. 8; p. 663
• Main Authors: Tamiya, Motohiro, Sasada, Shinji, Uehara, Nobuko, Okamoto, Norio, Kobayashi, Masashi, Shimada, Kazuki, Komori, Chika, Kuhara, Hanako, Honda, Hidehiro, Sakatani, Kazuyo, Minami, Toshiyuki, Morishita, Naoko, Suzuki, Hidekazu, Hirashima, Tomonori, Matsui, Kaoru, Kawahara, Kunimitu, Kawase, Ichiro, Kusunoki, Yoko
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-08-2009
• Subjects: Adult; Aged; Aged, 80 and over; Bronchoscopes; Bronchoscopy - methods; Female; Humans; Lung - pathology; Male; Middle Aged; Respiratory Distress Syndrome, Adult - diagnosis; Retrospective Studies
• ISSN: 1343-3490

We retrospectively reviewed the contribution of widely used devices such as the standard fiberoptic bronchoscope in the diagnosis of peripheral pulmonary lesions (PPLs) in patients who presented with respiratory distress.
We performed bronchoscopy for 106 PPLs in January-December 2007, and diagnosed access to the lesions to be difficult.
For these lesions, we applied Sasada transbronchial angled forceps (STAF), transbronchial needle aspiration cytology (TBAC), thin bronchoscopy, and ultra-thin bronchoscopy, which are widely used devices, after routinely performing biopsy with standard forceps and saved each specimen separately, and finally compared the pathological diagnosis.
The diagnostic yield obtained with specimens using standard forceps was 36.8%; however, the overall diagnosis was improved to 70.8% after we used these other devices and methods. We achieved diagnosis with STAF (10 lesions), followed by thin bronchoscopy (5 lesions), and ultra-thin bronchoscopy (14 lesions). No diagnosis was made by TBAC.
We conclude that these widely employed devices can contribute to improvements in the diagnosis of cases of respiratory distress in which arrival to the lesions is difficult.