Efficacy and Safety of Endobronchial Ultrasonography with a Guide-sheath for Acute Pulmonary Lesions in Patients with Haematological Diseases

Intern Med. 2022;61(5):623-632. doi: 10.2169/internalmedicine.6364-20. Epub 2022 Mar 1.

Abstract

Objective Acute pulmonary lesions (APLs), defined as an acute infiltrate or nodular lung field, are a major complication in patients with haematological diseases. Recently, endobronchial ultrasonography with a guide-sheath (EBUS-GS) was established as a useful technique for diagnosing pulmonary lesions. This study aimed to evaluate the efficacy and safety of EBUS-GS for managing APLs in patients with haematological diseases. Methods Our single-centre, retrospective, observational, single-arm, descriptive study enrolled 22 consecutive adult (>20-year-old) patients with haematological diseases and concomitant APL who underwent EBUS-GS between January 2011 and June 2016 at Kameda Medical Center, Chiba, Japan. The primary endpoint was the contribution of EBUS-GS to clinical decision-making. Secondary endpoints were an adequate tissue collection rate, diagnostic yield, complication rate, and 30-day mortality. Results The median patient age was 70 years old, and 63.6% were men. Acute myeloid leukaemia was the most frequent underlying disease, accounting for 54.5% of patients. The contribution of EBUS-GS to clinical decision-making was recognised in 11 (50.0%) patients. Adequate tissue collection was achieved in 21 (95.5%) patients. The aetiology of the APL was identified in 9 (40.9%) patients. No complications, including severe haemorrhaging and pneumothorax, were observed in any patients, and the 30-day mortality rate was 0%. Conclusion EBUS-GS may be a suitable diagnostic option for APL in patients with haematological diseases. Further larger-scale and randomised controlled trials are needed to confirm our results.

Keywords: adult; bronchoscopy; haematologic disease; image-guided biopsy; lung disease.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Bronchoscopy / methods
  • Endosonography / adverse effects
  • Endosonography / methods
  • Hematologic Diseases* / complications
  • Hematologic Diseases* / diagnostic imaging
  • Humans
  • Lung / pathology
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / diagnostic imaging
  • Male
  • Retrospective Studies
  • Young Adult