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Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
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New Nodule-Newer Etiology.

Atul C Mehta1, Juan Wang1, Sami Abuqayyas1

  • 1Atul C Mehta, Juan Wang, Sami Abuqayyas, Puneet Garcha, Charles Randy Lane, Wayne Tsuang, Marie Budev, Olufemi Akindipe, Respiratory Institute Cleveland Clinic, Cleveland, OH 44195, United States.

World Journal of Transplantation
|March 25, 2016
PubMed
Summary
This summary is machine-generated.

Flexible bronchoscopy with transbronchial biopsy in lung transplant recipients can cause new pulmonary nodules. These nodules are transient and appear to be related to the biopsy procedure itself.

Keywords:
Flexible bronchoscopyLung transplantPeripheral pulmonary noduleTransbronchial biopsy

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Area of Science:

  • Pulmonary Medicine
  • Transplant Surgery
  • Radiology

Background:

  • Lung transplant recipients (LTR) undergo flexible bronchoscopy (FB) with transbronchial biopsy (TBBx) for various indications.
  • The potential for iatrogenic complications following FB in LTR requires careful evaluation.

Purpose of the Study:

  • To determine the frequency of new pulmonary nodules (PN) after FB with TBBx in LTR.
  • To assess the temporal relationship between TBBx and the appearance/disappearance of these PNs.

Main Methods:

  • Retrospective review of 100 LTR records who underwent FB with TBBx.
  • Inclusion criteria: chest radiographs within 50 days of FB.
  • Comparison group: 30 procedures in non-transplant patients.

Main Results:

  • 19 new peripheral pulmonary nodules (PPNs) were identified in 13 LTR procedures (13%).
  • No PPNs were observed in the non-transplant control group.
  • Nodules appeared 4-47 days post-TBBx and resolved spontaneously within 84 days.

Conclusions:

  • FB with TBBx is associated with the development of new, transient PPNs in 13% of LTR procedures.
  • Hypothesized causes include local hematoma and impaired lymphatic drainage.
  • Observation is a suitable management strategy for these procedure-related nodules.