THE USE OF REBUS - RADIAL ENDOBRONCHIAL ULTRASONOGRAPHY IN THE DIAGNOSIS OF PERIPHERAL PULMONARY LESIONS (PPLS) OF SINGLE TB CENTRE EXPERIENCE

Abstract

TYPE: Abstract Publication TOPIC: Procedures PURPOSE: To assess the diagnostic yield of radial-EBUS for the diagnosis of PPLs in patients of TB clinic. METHODS: 127 patients aged from 13 to 80 years (55.1% female) underwent r-EBUS for the diagnosis of PPLs. All patients with suspected benign and malignant PPLs had smear negative tests of sputum for TB. We passed a radial 20 MHz miniprobe through the working channel of the bronchoscope and advanced in to the bronchus adjacent to the PPLs. After navigation rEBUS forceps biopsy (TBB - 84) and bronchial brush (121) were performed. Bronchoalveolar lavage (BAL) – (71) or Bronchial washing (BW) – (21) was also routinely performed after the biopsy techniques in patients with TB suspicious PPLs for Bactec MGIT 960 culture and TB PCR. RESULTS: R-EBUS found 81 nodules (2.1±0.73cm) and 41 masses (3.9±0.83cm) (122/127 (96,06%)). All procedures performed under local anesthesia. 2 AE were observed - 1 – pneumothorax, 1- moderate bleeding. Diagnosis of the PPLs were found in 101 of 122 (79.5%) patients including 40 malignancy PPLs (NSCLC in 32 cases, and 61 benign lesions (pulmonary TB in 40 cases). The brush, TBB, and BAL (BW) were diagnostic in 38/50 (76,0%), 29/44 (65,9%), and 7/24 (29,2%) patients with malignancy and in 37/44 (84.1%), 10/13 (76,9%), and 31/44 (70,4%) patients with TB pulmonary lesions, respectively. In all patients diagnosis TB supported by MGIT culture and additionally revealed 3 cases of NTM (MAC). CONCLUSIONS: The use of rEBUS allows receive the biopsy directly from the target lesions in patients with sputum-negative pulmonary TB. CLINICAL IMPLICATIONS: Not applicable DISCLOSURE: No significant relationships. KEYWORDS: lung cancer, tuberculosis, Bronchoscopy