The significance of radial endosonography of the lung parenchyma in the bronchoscopic diagnosis of PERIPHERAL PULMONARY LESIONS of tuberculous genesis

DOI: https://doi.org/10.29296/25877305-2021-07-10
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Issue: 
7
Year: 
2021

I. Shabalina, Candidate of Medical Sciences; Yu. Turovtseva; A. Popova; T. Smirnova, Candidate
of Medical Sciences; E. Larionova, Candidate of Biological Sciences; N. Karpina, MD; Professor A. Ergeshov,
MD Central Research Institute of Tuberculosis, Moscow

The minimally invasive differential diagnosis of peripheral pulmonary lesions (PPLs) is an urgent clinical problem, especially in high tuberculosis (TB) burden countries. Objective: to evaluate the comparative effectiveness of bronchoscopic biopsies with radial endobronchial ultrasonography (rEBUS navigation) and biopsies in conventional bronchoscopy (BS) with computed tomography (CT)-guided navigation in the diagnosis of PPLs of non-cancer genesis. Subjects and methods. The investigation enrolled 158 patients (78 males, 80 females) with PPLs, as evidenced by chest CT (CCT), and with a negative sputum microbiological test for Mycobacterium tuberculosis. The patients were divided into 2 groups: 1) 82 patients undergoing BS with rEBUS navigation; 2) 76 patients having BS with CT-guided navigation. For a comprehensive microbiological and cytomorphological study after rEBUS navigation, the patients underwent bronchoalveolar lavage (BAL) (n=121), brush biopsy (n=103), bronchial washings (n=31), and transbronchial lung biopsy (n=25). Results. The diagnosis of TB was verified with BS in 103 (65.2%) patients; it was significantly more often in the samples from the patients undergoing rEBUS navigation than from those having CT-guided navigation (80.5% vs. 48.7% of cases, respectively; p
Keywords: 
phthisiology
radial endobronchial ultrasonography
bronchoscopy
tuberculosis
polymerase chain reaction
BACTEC MGIT 960
bronchoalveolar lavage
bronchial washings
brush biopsy

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