Utility of virtual bronchoscopy-guided transbronchial biopsy for the diagnosis of pulmonary sarcoidosis: report of two cases.
Sarcoidosis is a multisystem granulomatous disease of unknown etiology that usually affects the lungs. Although flexible fiberoptic bronchoscopy with transbronchial lung biopsy (TBBx) has a high diagnostic yield in patients with pulmonary sarcoidosis, variously ranging from 40 to 90%, more invasive procedures often prove necessary. We report two cases of successful diagnosis of pulmonary sarcoidosis using a new technique that may increase the accuracy of TBBx. Previously described for diagnosis of peripheral lung cancer, this technique relies on real-time virtual bronchoscopic guidance to biopsy preselected peripheral areas of the lung preferentially affected by the disease using a pediatric bronchoscope. In each case, while procedures were performed under direct CT guidance allowing precise confirmation of the tip of the biopsy catheter, it is anticipated that this technique will be primarily used as a guide to bronchoscopic biopsies without the need for direct CT guidance, thus increasing routine utilization of multidetector low-dose high-resolution CT to improve histologic diagnosis.
Godoy
Myrna C B
MCB
Department of Radiology, New York University School of Medicine, New, York, NY.
Ost
David
D
Department of Pulmonary Medicine, New York University School of Medicine, New, York, NY.
Geiger
Bernhard
B
Siemens Corporate Research, Princeton, NJ.
Novak
Carol
C
Siemens Corporate Research, Princeton, NJ.
Nonaka
Daisuke
D
Department of Pathology, New York University Medical Center, New York University School of Medicine, New, York, NY.
Vlahos
Ioannis
I
Department of Radiology, New York University School of Medicine, New, York, NY.
Naidich
David P
DP
Department of Radiology, New York University School of Medicine, New, York, NY. Electronic address: david.naidich@nyumc.org.
D000328:Adult; D001706:Biopsy; D001999:Bronchoscopy / Q000379:methods*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D006801:Humans; D008168:Lung / Q000473:pathology*; D008297:Male; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000473:pathology; D014584:User-Computer Interface