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Case Reports
. 2021 May 10;9(6):e00766.
doi: 10.1002/rcr2.766. eCollection 2021 Jun.

Use of saline to evaluate a cavity due to Mycobacterium kansasii infection during ultrathin bronchoscopy and endobronchial ultrasonography

Megumi Hamaguchi  1 , Noriaki Kurimoto  1 , Yukari Tsubata  1 , Takae Okuno  1 , Akari Tanino  1 , Takamasa Hotta  1 , Takeshi Isobe  1
Affiliations
Case Reports

Use of saline to evaluate a cavity due to Mycobacterium kansasii infection during ultrathin bronchoscopy and endobronchial ultrasonography

Megumi Hamaguchi et al. Respirol Case Rep. .

Abstract

A 28-year-old man had a cavitary lesion in the upper right lobe with a tree-in-bud appearance on chest computed tomography (CT). Diagnostic bronchoscopy was performed. An ultrathin bronchoscope in the right B2aiiβxyy reached the cavity. We filled the cavity with saline under direct bronchoscopic visualization. We suspected a blood vessel was present in the cavity wall based on narrow-band imaging. Bronchial lavage of the cavity was performed. Next, endobronchial ultrasonography (EBUS) using a guide sheath was performed with a thin bronchoscope. EBUS showed a pulsating blood vessel in the cavity wall. Bronchial lavage collected with ultrathin and thin bronchoscopy revealed Mycobacterium kansasii. Observation of vessels in the wall of a cavitary lesion with ultrathin bronchoscopy and EBUS may be useful for avoiding severe bleeding associated with biopsy of a cavitary lesion.

Keywords: Cavity; Mycobacterium kansasii; endobronchial ultrasonography; thin bronchoscope; ultrathin bronchoscope.

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Figures

Figure 1
Figure 1
(A) Granular shadows in the upper right lung field on a chest radiograph. (B, C) A cavitary lesion in the upper right lobe with a tree‐in‐bud appearance was observed with high‐resolution computed tomography.
Figure 2
Figure 2
(A) Findings observed with an ultrathin bronchoscope inside the cavity. A blood vessel running in the superficial tissue was observed (red arrow). (B) Narrow‐band imaging (NBI) showed a brownish blood vessel (red arrow). (C) Observing the cavity with endobronchial ultrasonography (EBUS), EBUS showed a blood vessel running in the cavity wall (red arrow).
See this image and copyright information in PMC

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