title: Radial Ultrasound-Assisted Transbronchial Biopsy: A New Diagnostic Approach for Non-Resolving Pulmonary Infiltrates in Neutropenic Hemato-Oncological Patients.
abstract: The role of radial-endobronchial ultrasound (R-EBUS) assisted transbronchial biopsy (TBB) for the diagnosis of peripheral pulmonary lesions is well established. However, no study has addressed its safety and value in hemato-oncological patients presenting with non-resolving infiltrates during persistent febrile neutropenia. To assess safety and feasibility of R-EBUS assisted TBB in severe thrombocytopenic and neutropenic patients. Over a period of 18 months, eight patients were assessed with R-EBUS assisted TBB after adequate platelet transfusion. This technique allowed precise localisation and sampling of the pulmonary lesions in seven of eight patients. In the seven patients, R-EBUS assisted TBB enabled treatment optimization. Invasive fungal infection was diagnosed in four patients, idiopathic acute fibrinous and organising pneumonia in three patients, and a granulomatous inflammation of undetermined origin in one patient. Importantly, no complications, such as bleeding, were observed. R-EBUS assisted TBB is a promising and safe procedure for the evaluation of nonresolving pulmonary infiltrates in febrile neutropenic hemato-oncological patients.
authors.affiliation: Division of Pneumology, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, Lausanne, 1011, Switzerland.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bernasconi
authors.affiliation: Division of Pneumology, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, Lausanne, 1011, Switzerland. Alessio.Casutt@gmail.com.
authors.forename: Alessio
authors.initials: A
authors.lastname: Casutt
authors.affiliation: Division of Pneumology, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, Lausanne, 1011, Switzerland.
authors.forename: Angela
authors.initials: A
authors.lastname: Koutsokera
authors.affiliation: Department of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Igor
authors.initials: I
authors.lastname: Letovanec
authors.affiliation: Division of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Tissot
authors.affiliation: Division of Pneumology, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, Lausanne, 1011, Switzerland.
authors.forename: Laurent P
authors.initials: LP
authors.lastname: Nicod
authors.affiliation: Division of Pneumology, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, Lausanne, 1011, Switzerland.
authors.forename: Alban
authors.initials: A
authors.lastname: Lovis
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D019160:Endosonography / Q000009:adverse effects / Q000379:methods; D005240:Feasibility Studies; D015769:Granuloma, Respiratory Tract / Q000175:diagnosis*; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis* / Q000209:etiology; D061705:Image-Guided Biopsy / Q000009:adverse effects; D000072742:Invasive Fungal Infections / Q000175:diagnosis* / Q000382:microbiology; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications*; D011014:Pneumonia / Q000175:diagnosis* / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents
keywords: Acute fibrinous and organising pneumonia; Non-resolving pulmonary infiltrates; Radial-endobronchial ultrasound; persistent febrile neutropenia