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array:23 [ "pii" => "S0300289624001753" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.05.014" "estado" => "S300" "fechaPublicacion" => "2024-10-01" "aid" => "3572" "copyright" => "SEPAR" "copyrightAnyo" => "2024" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2024;60:666-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0300289624001716" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.05.010" "estado" => "S300" "fechaPublicacion" => "2024-10-01" "aid" => "3568" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2024;60:668-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "The Effect of Bronchoscopic Lung Volume Reduction on Hemidiaphragm Excursion" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "668" "paginaFinal" => "669" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1509 "Ancho" => 2255 "Tamanyo" => 336114 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">High-resolution CT thorax showing upper lobe predominant heterogeneous emphysema with centrilobular distribution in the right lung (<span class="elsevierStyleItalic">Panel A</span>) and complete fissure integrity (<span class="elsevierStyleItalic">Panel B</span>). Absence of collateral ventilation confirmed by occlusion of the right upper lobe ostium with the Chartis® balloon (<span class="elsevierStyleItalic">Panel C</span>). Deployment of three endobronchial valves in the anterior, posterior, and apical segments of the right upper lobe (<span class="elsevierStyleItalic">Panel D</span>).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sze Shyang Kho, Shan Khai Ing, Siew Teck Tie" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Sze Shyang" "apellidos" => "Kho" ] 1 => array:2 [ "nombre" => "Shan Khai" "apellidos" => "Ing" ] 2 => array:2 [ "nombre" => "Siew Teck" "apellidos" => "Tie" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001716?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000010/v1_202410020659/S0300289624001716/v1_202410020659/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289624001728" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.05.011" "estado" => "S300" "fechaPublicacion" => "2024-10-01" "aid" => "3569" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2024;60:664-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Sometimes it's What it Doesn’t Look Like: Atypical Dissemination of Lung Adenocarcinoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "664" "paginaFinal" => "665" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3573 "Ancho" => 2510 "Tamanyo" => 888191 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical case images: chest X-ray, computed tomography scan and positron emission tomography/computed tomography. Posteroanterior (A) and lateral (B) chest X-ray with bilateral nodular pattern. Chest computed tomography showing the lung mass (asterisk) in left lower lobe (coronal (C) and axial (E) views) with multiple bilateral ground-glass nodules, with a tendency to cavitation better defined in lower lobes (lateral view (D)). Fluorine-18 fluorodeoxyglucose positron emission tomography (E) with pathologic increased uptake in the mass, with unspecific low generalized metabolic activity.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Miguel Jiménez-Gómez, Ignacio Alba-de-Cáceres, José Ignacio de-Granda-Orive" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Miguel" "apellidos" => "Jiménez-Gómez" ] 1 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Alba-de-Cáceres" ] 2 => array:2 [ "nombre" => "José Ignacio" "apellidos" => "de-Granda-Orive" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001728?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000010/v1_202410020659/S0300289624001728/v1_202410020659/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Endobronchial Hamartoma Resected by Flexible Bronchoscopy: A Complex Approach" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "666" "paginaFinal" => "667" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Joana Lourenço, Luís Rodrigues, Paulo Matos, Michele Santis, Amélia Estevão, Lourdes Barradas" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Joana" "apellidos" => "Lourenço" "email" => array:1 [ 0 => "joanacnlourenco@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Luís" "apellidos" => "Rodrigues" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Paulo" "apellidos" => "Matos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Michele" "apellidos" => "Santis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Amélia" "apellidos" => "Estevão" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "Lourdes" "apellidos" => "Barradas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Pulmonology Department, Pedro Hispano Hospital, Matosinhos Local Health Unit, Oporto, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Pulmonology Department, Francisco Gentil Portuguese Institute of Oncology of Coimbra, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Radiology Department, CUF Hospital, Coimbra, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1395 "Ancho" => 2000 "Tamanyo" => 359268 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A and B) Initial chest computed tomography revealing a lesion (red arrow) at the left main bronchial bifurcation; (C) air entrapment observed in the left lung during expiratory phase in chest computed tomography; (D) endoscopic view of the left main bronchus; (E) bronchial repermeabilization process using cryoablation and argon-plasma coagulation by flexible bronchoscopy; (F) endoscopic view of the left main bronchus after endoscopic resection; (G) endoscopic view inside left b6 segment showing a small remaining lesion (yellow arrow) at a b6 subdivision; (H) chest computed tomography follow-up, 1 month after endoscopic resection, identifying a residual endobronchial lesion (red arrow) at the left b6 segment; (I) endoscopic view of left b6 segment showing a growing lesion (yellow arrow), 2 months after endoscopic resection; (J) endoscopic view inside left b6 segment after the second endoscopic treatment; (K) endoscopic view of left b6 segment, 3 months after the first resection.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 59-year-old ex-smoker man, presented with progressive dyspnoea and wheezing for several years, interpreted as asthma unresponsive to inhaled therapy. Chest CT (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B) revealed extensively calcified lesion measuring 17<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>9.5<span class="elsevierStyleHsp" style=""></span>mm at the left main bronchial bifurcation, partially obstructing the lumen, with air entrapment observed in the left lung during expiratory phase (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). First bronchoscopic examination showed a large lobulated and vascularized lesion with a firm consistency, on the superolateral wall of the left main bronchus (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D), causing complete obstruction of the bronchial lumen. Bronchial repermeabilization was possible after endoscopic treatment using a diathermic loop and 1.7<span class="elsevierStyleHsp" style=""></span>mm cryoprobe (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>E). Additional haemostatic control was obtained with tangential argon-plasma coagulation (APC) and Arndt endobronchial blocker placed prophylactically. Only a residual lesion remained at a b6 subdivision (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>F and G). Histology revealed chondroid hamartoma. Follow-up chest CT identified residual endobronchial lesion (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>H) measuring 7<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mm at the left b6 segment and therefore a second bronchoscopy was performed, 2 months after the initial procedure. The residual polypoid lesion (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>I) was resected with an electrocoagulation loop in combination with a cryoprobe and APC (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>J). Endobronchial follow-up at 3 months showed no recurrence of the hamartoma (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>K).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Endobronchial types account for less than 10% of pulmonary hamartomas.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> Although most pulmonary hamartomas are asymptomatic and found incidentally, endobronchial forms often present with symptoms (persistent cough, wheezing or haemoptysis) and have a higher likelihood of airway obstruction and pneumonia.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a> Differential diagnosis includes malignant tumours and foreign body aspiration. Endoscopic resection of endobronchial hamartomas may present as definitive treatment and is generally performed by rigid bronchoscopy.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> Nevertheless, in cases involving distal lesions, flexible bronchoscopy may be preferred over traditional rigid bronchoscopy, enabling further techniques such as loop, cryoprobe, APC and endobronchial blocking.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,3</span></a> Guidelines regarding endoscopic follow-up in these cases are insufficient in literature.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors’ Contributions</span><p id="par0020" class="elsevierStylePara elsevierViewall">All authors had contributed substantially to obtain the results and preparation of the manuscript in accordance with ICMJE criteria.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of Interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare not to have any conflicts of interest that may be considered to influence directly or indirectly the content of the manuscript.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Artificial Intelligence Involvement</span><p id="par0030" class="elsevierStylePara elsevierViewall">No artificial intelligence software or tool were used to produce the material of this paper.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Authors’ Contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of Interest" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Artificial Intelligence Involvement" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1395 "Ancho" => 2000 "Tamanyo" => 359268 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A and B) Initial chest computed tomography revealing a lesion (red arrow) at the left main bronchial bifurcation; (C) air entrapment observed in the left lung during expiratory phase in chest computed tomography; (D) endoscopic view of the left main bronchus; (E) bronchial repermeabilization process using cryoablation and argon-plasma coagulation by flexible bronchoscopy; (F) endoscopic view of the left main bronchus after endoscopic resection; (G) endoscopic view inside left b6 segment showing a small remaining lesion (yellow arrow) at a b6 subdivision; (H) chest computed tomography follow-up, 1 month after endoscopic resection, identifying a residual endobronchial lesion (red arrow) at the left b6 segment; (I) endoscopic view of left b6 segment showing a growing lesion (yellow arrow), 2 months after endoscopic resection; (J) endoscopic view inside left b6 segment after the second endoscopic treatment; (K) endoscopic view of left b6 segment, 3 months after the first resection.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endobronchial hamartoma – a 10-year retrospective analyses of bronchoscopy treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.G. Cardoso" 1 => "M. Martins" 2 => "C. Souto-Moura" 3 => "G. Fernandes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.pulmoe.2022.07.002" "Revista" => array:6 [ "tituloSerie" => "Pulmonology" "fecha" => "2023" "volumen" => "29" "paginaInicial" => "89" "paginaFinal" => "91" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36117101" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endobronchial hamartoma as a rare cause of recurrent respiratory symptoms: case report and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Minalyan" 1 => "N. Gopisetti" 2 => "A. Estepa" 3 => "H. Grover" 4 => "R. Patel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7759/cureus.5489" "Revista" => array:5 [ "tituloSerie" => "Cureus" "fecha" => "2019" "volumen" => "11" "paginaInicial" => "e5489" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31656715" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endobronchial hamartoma resected via bronchoscopy using high-frequency electrosurgical snare – preoperative strategies using virtual bronchoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Suzuki" 1 => "H. Watanabe" 2 => "M. Hashimoto" 3 => "S. Ishii" 4 => "G. Naka" 5 => "M. Iikura" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.radcr.2022.08.018" "Revista" => array:6 [ "tituloSerie" => "Radiol Case Rep" "fecha" => "2022" "volumen" => "17" "paginaInicial" => "4232" "paginaFinal" => "4238" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36120524" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000006000000010/v1_202410020659/S0300289624001753/v1_202410020659/en/main.assets" "Apartado" => array:4 [ "identificador" => "98298" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cllinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000006000000010/v1_202410020659/S0300289624001753/v1_202410020659/en/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001753?idApp=UINPBA00003Z" ]
