Ye Gu1, Chunyan Wu2, Fangyou Yu3, Xuwei Gui4, Jun Ma4, Liping Cheng4, Qin Sun4, Wei Sha4. 1. Department of Bronchoscopy, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China. 2. Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China. 3. Clinical Laboratory, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China. 4. Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
Abstract
BACKGROUND: In the absence of a positive sputum bacteriological result, pathological and bacteriological examinations of lung lesion biopsies are important methods to confirm bacteriological-negative tuberculosis. Endobronchial ultrasonography with guide sheath (EBUS-GS) and electromagnetic navigation bronchoscopy (ENB) are two new endobronchial diagnostic techniques, the combination of which has greatly facilitated the diagnosis of peripheral pulmonary lesions and is an especially useful, minimally invasive, effective diagnostic method for bacteriologically-negative tuberculosis cases. METHODS: A total of 78 patients were included in this study with suspected pulmonary tuberculosis based on clinical manifestations, laboratory tests, and imaging studies. The patients underwent a high-resolution chest CT scan before bronchoscopy, A method was selected (EBUS-GS alone, or EBUS-GS + ENB) based on the lesion site and the level and angle of the bronchus involved. After the lesion was found, a puncture needle, biopsy forceps, and brushing forceps were used to collect a tissue sample. RESULTS: Forty-four patients were diagnosed with tuberculosis; 1, nontuberculous Mycobacteria (NTM) lung disease; 15, lung cancer; 15, pulmonary infection; 1, allergic bronchopulmonary aspergillosis (ABPA); and 2, pneumoconiosis. A total of 25 patients of TB (56.8%) were successfully diagnosed with EBUS-GS plus ENB. Among the patients with confirmed diagnosis, 9 were diagnosed with pathological examination; 4, genetic analysis; 11, positive smear; and 14, positive culture. CONCLUSIONS: The introduction of EBUS and ENB in China has provided a new direction for the diagnosis of atypical bacteriological-negative tuberculosis, as the techniques are less invasive and less expensive than thoracoscopy. 2019 Annals of Translational Medicine. All rights reserved.
BACKGROUND: In the absence of a positive sputum bacteriological result, pathological and bacteriological examinations of lung lesion biopsies are important methods to confirm bacteriological-negative tuberculosis. Endobronchial ultrasonography with guide sheath (EBUS-GS) and electromagnetic navigation bronchoscopy (ENB) are two new endobronchial diagnostic techniques, the combination of which has greatly facilitated the diagnosis of peripheral pulmonary lesions and is an especially useful, minimally invasive, effective diagnostic method for bacteriologically-negative tuberculosis cases. METHODS: A total of 78 patients were included in this study with suspected pulmonary tuberculosis based on clinical manifestations, laboratory tests, and imaging studies. The patients underwent a high-resolution chest CT scan before bronchoscopy, A method was selected (EBUS-GS alone, or EBUS-GS + ENB) based on the lesion site and the level and angle of the bronchus involved. After the lesion was found, a puncture needle, biopsy forceps, and brushing forceps were used to collect a tissue sample. RESULTS: Forty-four patients were diagnosed with tuberculosis; 1, nontuberculous Mycobacteria (NTM) lung disease; 15, lung cancer; 15, pulmonary infection; 1, allergic bronchopulmonary aspergillosis (ABPA); and 2, pneumoconiosis. A total of 25 patients of TB (56.8%) were successfully diagnosed with EBUS-GS plus ENB. Among the patients with confirmed diagnosis, 9 were diagnosed with pathological examination; 4, genetic analysis; 11, positive smear; and 14, positive culture. CONCLUSIONS: The introduction of EBUS and ENB in China has provided a new direction for the diagnosis of atypical bacteriological-negative tuberculosis, as the techniques are less invasive and less expensive than thoracoscopy. 2019 Annals of Translational Medicine. All rights reserved.
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