Sentinel Lymph Node (SLN) Biopsy in Clinically Node Positive Disease

Abstract

2003 management algorithm, because it is quite similar to our own treatment protocol reported in 1989. Although this patient responded to CT-guided drainage, we concur that some are recalcitrant to percutaneous interventions. We also have performed formal lung resection in patients with pneumatoceles unresponsive to minimally invasive procedures, with 25% of patients requiring resection for definitive management in our earlier study. In our experience, there may also be a role for transbronchial decompression to avoid bronchopleural fistulas. Alternatively, in patients undergoing percutaneous drainage who develop persistent bronchopleural fistulas, fibrin glue or Bioglue (Cryolife) might be a therapeutic option before thoracotomy for definitive treatment. In response to Dr Santos’s discussion of nomenclatures, we agree that terminology is important, especially with renewed efforts in and focus on accuracy and patient safety. Assigning appropriate phraseology to this pulmonary parenchymal disruption appears to be confusing for others as well, with only 16 “correct” references in the literature out of 41 articles. Similarly, trauma and critical care texts uniformly use alternate monikers rather than traumatic pulmonary pseudocyst. Even Dorland’s Medical Dictionary recognizes both pulmonary pseudocysts and pneumatoceles. We acknowledge colloquial verbiage often predominates in daily language over proper terminology, but recognize this confusion should be resolved. Our article should be entitled “Posttraumatic Pulmonary Pseudocyst.”