title: Image-guided bronchoscopy for histopathologic diagnosis of pure ground glass opacity: a case report.
abstract: Guided bronchoscopy has been found to be useful for the diagnosis of solid peripheral pulmonary lesions (PPLs) but more evidence on ground glass opacities (GGOs), especially those without a solid component, are lacking. A 69-year-old male, asymptomatic, heavy smoker was referred to our department for non-surgical diagnosis of a focal pure GGO in the right upper lobe that was found incidentally on computed tomography (CT). Transbronchial biopsy (TBB) with the aide of endobronchial ultrasound with a guide sheath (EBUS-GS), virtual bronchoscopic navigation (VBN), and fluoroscopy was performed for sampling. There were no complications after the procedure. The diagnosis of adenocarcinoma with lepidic growth pattern was established from the fourth and fifth TBB specimens and was confirmed on subsequent surgical resection. Image-guided bronchoscopy with TBB was successful for the diagnosis of a pure GGO. Use of a larger biopsy device may be helpful for the histopathologic diagnosis of lung adenocarcinoma with lepidic growth.
authors: 1 Respiratory Endoscopy Division, Department of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan ; 2 Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-Cho, Hodogaya-ku, Yokohama, Kanagawa 240-8555, Japan ; 3 Department of Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan.
authors: Christine
authors: C
authors: Chavez
authors: 1 Respiratory Endoscopy Division, Department of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan ; 2 Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-Cho, Hodogaya-ku, Yokohama, Kanagawa 240-8555, Japan ; 3 Department of Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan.
authors: Shinji
authors: S
authors: Sasada
authors: 1 Respiratory Endoscopy Division, Department of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan ; 2 Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-Cho, Hodogaya-ku, Yokohama, Kanagawa 240-8555, Japan ; 3 Department of Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan.
authors: Takehiro
authors: T
authors: Izumo
authors: 1 Respiratory Endoscopy Division, Department of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan ; 2 Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-Cho, Hodogaya-ku, Yokohama, Kanagawa 240-8555, Japan ; 3 Department of Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan.
authors: Yukiko
authors: Y
authors: Nakamura
authors: 1 Respiratory Endoscopy Division, Department of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan ; 2 Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-Cho, Hodogaya-ku, Yokohama, Kanagawa 240-8555, Japan ; 3 Department of Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan.
authors: Koji
authors: K
authors: Tsuta
authors: 1 Respiratory Endoscopy Division, Department of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan ; 2 Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-Cho, Hodogaya-ku, Yokohama, Kanagawa 240-8555, Japan ; 3 Department of Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan.
authors: Takaaki
authors: T
authors: Tsuchida
keywords: Endobronchial ultrasound with a guide sheath (EBUS-GS); ground glass opacity (GGO); peripheral pulmonary lesion (PPL); radial EBUS; transbronchial biopsy (TBB)