Abstract
In the present day, small solitary pulmonary cancer is detected to a great extent from lung cancer screening programs using low dose computed tomography (CT) scans. The smaller the nodules are, the more challenging tissue biopsies are. Non-subpleural, peripheral pulmonary nodules are the most difficult areas to obtain a tissue biopsy. In patients who failed CT Guided biopsy or Electromagnetic Navigation Bronchoscopy (ENB) with biopsy, Video Assisted Thoracic Surgery (VATS) with biopsy under dye marking can be performed to make a definite diagnosis. We report a case where we performed navigation bronchoscopy with dye marking for the first time in Thailand as a diagnosis option to offer this group of patients.
Highlights
In the present day, small solitary pulmonary cancer is detected to a great extent from lung cancer screening programs using low dose computed tomography (CT) scans
We report a case where we performed navigation bronchoscopy with dye marking for the first time in Thailand as a diagnosis option to offer this group of patients
The nodule was located in the intersegmental plane between apical segment and posterior segment as we reviewed on chest CT
Summary
Small solitary pulmonary cancer is detected to a great extent from lung cancer screening programs using low dose computed tomography (CT) scans. We started to navigate from posterior segment of right upper lobe bronchus and reached 1 cm away from center of target the locatable guide was removed from the extended working channel (Figure 3B). We attempted to palpate the specimen but we failed to identify it so it was opened sharply and we were able to identify the lesion It was marked by suture material, sent for frozen section and it was found to have 0.4 x 0.3 firm scar at targeted area so the operation was concluded. 2B: Distance of locatable guide (grey rod) to target center (green spot) was 1 cm in coronal plane, white area showed chest wall. 2C: Right box showed distance of locatable guide (grey rod) to target center (green spot) at 2.2 cm in coronal plane on superior end Left upper box showed the pathway from posterior segment of right upper lobe bronchus on inferior end. 2C: Right box showed distance of locatable guide (grey rod) to target center (green spot) at 2.2 cm in coronal plane on superior end
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