Scientific Letter
Biopsy of Intrapulmonary Lesions in Lungs with Atelectasis and Pleural Effusion
Biopsia de lesiones intrapulmonares en pulmones con atelectasia y derrame pleural
Francisco Julián López Gonzáleza,
, Lucía García Alfonsoa, Juan Cascón Hernándeza, Miguel Ariza Protaa, Julia Herrero Huertasa, Tamara Hermida Valverdea, Inés Ruíz Álvarezb, Hector Enrique Torres Rivasc, Luis Manuel Fernández Fernándezc, Ana Isabel Enríquez Rodrígueza, Marta María García Clementea, Virgina Gallo Gonzálezd
Corresponding author
a Área de Gestión Clínica del Pulmón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
b Sección de Neumología, Hospital Alvarez-Buylla, Mieres, Asturias, Spain
c Servicio de Anatomía Patológica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
d Servicio de Neumología, Hospital Gregorio Marañón, Madrid, Spain
Read
3026
Timeswas read the article
866
Total PDF
2160
Total HTML
Share statistics
array:24 [ "pii" => "S157921292100118X" "issn" => "15792129" "doi" => "10.1016/j.arbr.2021.04.005" "estado" => "S300" "fechaPublicacion" => "2021-06-01" "aid" => "2624" "copyright" => "SEPAR" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2021;57:438-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289620303057" "issn" => "03002896" "doi" => "10.1016/j.arbres.2020.09.002" "estado" => "S300" "fechaPublicacion" => "2021-06-01" "aid" => "2624" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2021;57:438-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta Científica</span>" "titulo" => "Biopsia de lesiones intrapulmonares en pulmones con atelectasia y derrame pleural" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "438" "paginaFinal" => "439" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Biopsy of Intrapulmonary Lesions in Lungs with Atelectasis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1046 "Ancho" => 1300 "Tamanyo" => 190987 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ecografía modo B que muestra imagen de ecoestructura heterogénea (flechas negras) correspondiente a atelectasia pulmonar con pequeño derrame pleural (área anecoica señalada con doble flecha). En el interior de la atelectasia se identifica lesión hipoecoica (asterisco) correspondiente a la lesión nodular a biopsiar. Las imágenes lineales hiperecoicas (flechas blancas) corresponden a la BAG.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisco Julián López González, Lucía García Alfonso, Juan Cascón Hernández, Miguel Ariza Prota, Julia Herrero Huertas, Tamara Hermida Valverde, Inés Ruíz Álvarez, Hector Enrique Torres Rivas, Luis Manuel Fernández Fernández, Ana Isabel Enríquez Rodríguez, Marta María García Clemente, Virgina Gallo González" "autores" => array:12 [ 0 => array:2 [ "nombre" => "Francisco Julián" "apellidos" => "López González" ] 1 => array:2 [ "nombre" => "Lucía" "apellidos" => "García Alfonso" ] 2 => array:2 [ "nombre" => "Juan" "apellidos" => "Cascón Hernández" ] 3 => array:2 [ "nombre" => "Miguel" "apellidos" => "Ariza Prota" ] 4 => array:2 [ "nombre" => "Julia" "apellidos" => "Herrero Huertas" ] 5 => array:2 [ "nombre" => "Tamara" "apellidos" => "Hermida Valverde" ] 6 => array:2 [ "nombre" => "Inés" "apellidos" => "Ruíz Álvarez" ] 7 => array:2 [ "nombre" => "Hector Enrique" "apellidos" => "Torres Rivas" ] 8 => array:2 [ "nombre" => "Luis Manuel" "apellidos" => "Fernández Fernández" ] 9 => array:2 [ "nombre" => "Ana Isabel" "apellidos" => "Enríquez Rodríguez" ] 10 => array:2 [ "nombre" => "Marta María" "apellidos" => "García Clemente" ] 11 => array:2 [ "nombre" => "Virgina" "apellidos" => "Gallo González" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S157921292100118X" "doi" => "10.1016/j.arbr.2021.04.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921292100118X?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620303057?idApp=UINPBA00003Z" "url" => "/03002896/0000005700000006/v1_202106020839/S0300289620303057/v1_202106020839/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212921001191" "issn" => "15792129" "doi" => "10.1016/j.arbr.2021.04.006" "estado" => "S300" "fechaPublicacion" => "2021-06-01" "aid" => "2625" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2021;57:440-2" "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">Scientific Letter</span>" "titulo" => "Study of the Diagnostic Delay of Tuberculosis in Spain" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "440" "paginaFinal" => "442" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estudio del retraso diagnóstico de la tuberculosis en España" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Asunción Seminario, Luis Anibarro, Josefina Sabriá, Marta María García-Clemente, Adrián Sánchez-Montalván, Juan Francisco Medina, Isabel Mir, Antón Penas, José Antonio Caminero, Guillermo José Pérez, Nieves Altet, Ángel Domínguez, María Ángeles Jiménez-Fuentes, Sarái Quirós, Eva María Tabernero, María Luiza De Souza-Galvão, Antonia Sáez, Joan Artur Caylà, José María García-García, Teresa Rodrigo" "autores" => array:21 [ 0 => array:2 [ "nombre" => "Asunción" "apellidos" => "Seminario" ] 1 => array:2 [ "nombre" => "Luis" "apellidos" => "Anibarro" ] 2 => array:2 [ "nombre" => "Josefina" "apellidos" => "Sabriá" ] 3 => array:2 [ "nombre" => "Marta María" "apellidos" => "García-Clemente" ] 4 => array:2 [ "nombre" => "Adrián" "apellidos" => "Sánchez-Montalván" ] 5 => array:2 [ "nombre" => "Juan Francisco" "apellidos" => "Medina" ] 6 => array:2 [ "nombre" => "Isabel" "apellidos" => "Mir" ] 7 => array:2 [ "nombre" => "Antón" "apellidos" => "Penas" ] 8 => array:2 [ "nombre" => "José Antonio" "apellidos" => "Caminero" ] 9 => array:2 [ "nombre" => "Guillermo José" "apellidos" => "Pérez" ] 10 => array:2 [ "nombre" => "Nieves" "apellidos" => "Altet" ] 11 => array:2 [ "nombre" => "Ángel" "apellidos" => "Domínguez" ] 12 => array:2 [ "nombre" => "María Ángeles" "apellidos" => "Jiménez-Fuentes" ] 13 => array:2 [ "nombre" => "Sarái" "apellidos" => "Quirós" ] 14 => array:2 [ "nombre" => "Eva María" "apellidos" => "Tabernero" ] 15 => array:2 [ "nombre" => "María Luiza De" "apellidos" => "Souza-Galvão" ] 16 => array:2 [ "nombre" => "Antonia" "apellidos" => "Sáez" ] 17 => array:2 [ "nombre" => "Joan Artur" "apellidos" => "Caylà" ] 18 => array:2 [ "nombre" => "José María" "apellidos" => "García-García" ] 19 => array:2 [ "nombre" => "Teresa" "apellidos" => "Rodrigo" ] 20 => array:1 [ "colaborador" => "Working Group of the Integrated Tuberculosis Research Program (PII-TB) of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289620303069" "doi" => "10.1016/j.arbres.2020.09.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620303069?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921001191?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000006/v1_202106020827/S1579212921001191/v1_202106020827/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1579212921001609" "issn" => "15792129" "doi" => "10.1016/j.arbr.2020.12.007" "estado" => "S300" "fechaPublicacion" => "2021-06-01" "aid" => "2694" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2021;57:436-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "A Rare Mass in the Mediastinum" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "436" "paginaFinal" => "437" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Una masa extraña en el mediastino" ] ] "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" => 891 "Ancho" => 1674 "Tamanyo" => 137715 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Thoracic X-ray showing a heterogenous right-sided mass continuous to the mediastinum (black arrow) and multiple pulmonary well-defined opacities (white arrows); (B) Coronal section on thoracic CT-scan showing a heterogeneous solid mediastinal mass (black arrow), touching the right atrium and diaphragm, and two pulmonary solid nodules on the left lung (white arrows); (C) Axial section on thoracic CT-scan presenting the anterior mediastinal mass (black arrow) contacting the ascending aorta, and left and right pulmonary nodules suggesting various metastasis (white arrows).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Margarida Pimenta Valério, Rita S. Lopes, Bárbara Ramos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Margarida" "apellidos" => "Pimenta Valério" ] 1 => array:2 [ "nombre" => "Rita S." "apellidos" => "Lopes" ] 2 => array:2 [ "nombre" => "Bárbara" "apellidos" => "Ramos" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921001609?idApp=UINPBA00003Z" "url" => "/15792129/0000005700000006/v1_202106020827/S1579212921001609/v1_202106020827/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Biopsy of Intrapulmonary Lesions in Lungs with Atelectasis and Pleural Effusion" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "438" "paginaFinal" => "439" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francisco Julián López González, Lucía García Alfonso, Juan Cascón Hernández, Miguel Ariza Prota, Julia Herrero Huertas, Tamara Hermida Valverde, Inés Ruíz Álvarez, Hector Enrique Torres Rivas, Luis Manuel Fernández Fernández, Ana Isabel Enríquez Rodríguez, Marta María García Clemente, Virgina Gallo González" "autores" => array:12 [ 0 => array:4 [ "nombre" => "Francisco Julián" "apellidos" => "López González" "email" => array:1 [ 0 => "fjlopezglez@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Lucía" "apellidos" => "García Alfonso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Juan" "apellidos" => "Cascón Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Miguel" "apellidos" => "Ariza Prota" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Julia" "apellidos" => "Herrero Huertas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Tamara" "apellidos" => "Hermida Valverde" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "Inés" "apellidos" => "Ruíz Álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 7 => array:3 [ "nombre" => "Hector Enrique" "apellidos" => "Torres Rivas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 8 => array:3 [ "nombre" => "Luis Manuel" "apellidos" => "Fernández Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 9 => array:3 [ "nombre" => "Ana Isabel" "apellidos" => "Enríquez Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 10 => array:3 [ "nombre" => "Marta María" "apellidos" => "García Clemente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 11 => array:3 [ "nombre" => "Virgina" "apellidos" => "Gallo González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Área de Gestión Clínica del Pulmón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Sección de Neumología, Hospital Alvarez-Buylla, Mieres, Asturias, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Gregorio Marañón, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Biopsia de lesiones intrapulmonares en pulmones con atelectasia y derrame pleural" ] ] "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" => 1046 "Ancho" => 1300 "Tamanyo" => 190987 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">B-mode ultrasound showing heterogeneous echostructure (black arrows) corresponding to pulmonary atelectasis with small pleural effusion (anechoic area indicated with double arrow). Hypoechoic lesion (asterisk) corresponding to the nodular lesion to be biopsied identified inside the atelectasis. The hyperechoic linear images (white arrows) correspond to core needle biopsy.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Lung cancer is the leading cause of cancer death in both sexes worldwide.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a> Typical techniques for the anatomopathological diagnosis of lung lesions are transthoracic needle aspiration and biopsy obtained by fiberoptic bronchoscopy. The first can be performed by fine needle aspiration and biopsy (FNAB) or by core needle biopsy (CNB), guided by either ultrasound or computed tomography (CT), depending on the site of the lesion. The second technique includes bronchial biopsy of lesions visible on endoscopy, linear endobronchial ultrasound-guided aspiration of nodules or mediastinal lymphadenopathies, and radial endobronchial ultrasound with electromagnetic navigation to sample lesions located in the periphery of the lung and thus not accessible by conventional bronchoscopy.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The technique is selected on the basis of a series of parameters, such as lesion site, the presence of pulmonary emphysema, or other comorbidities. In recent years we have witnessed the rise of thoracic ultrasound, both in the diagnosis of different lung diseases and in interventions, and this technique is proving useful for guiding lung lesion biopsies.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">3,4</span></a> Because air does not transmit ultrasounds, lesions must be located in the periphery of the lung or within a suitable acoustic window. Although ultrasound-guided biopsy of lesions in central lung cancer with atelectasis has been described,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> very few reports have been published in the literature on ultrasound-guided biopsy of intrapulmonary nodular lesions in patients with atelectasis and pleural effusion.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We report a series of 5 patients who, between August 2017 and December 2019, underwent transthoracic biopsy of central lung lesions in the presence of atelectasis and pleural effusion, in whom no nodular lesions were clearly visualized on chest CT. We used a Siemens Acuson X300™ echograph for this study. Color Doppler was used at the entry point to minimize the risk of puncturing vascular structures. All procedures were performed by a single operator using the freehand technique. The probe size was selected on the basis of the distance from the chest wall to the lesion. A linear probe (6.2–10<span class="elsevierStyleHsp" style=""></span>MHz) was used in 3 cases, a convex probe (1.5–5<span class="elsevierStyleHsp" style=""></span>MHz) was used in another case, and in 1 case both types of probe were used. A Trucut-type core needle (Acecut®, TSK Laboratory, Europe, Molenstraat 15, 2513 BH, The Hague, The Netherlands), 14<span class="elsevierStyleHsp" style=""></span>G in diameter and 22<span class="elsevierStyleHsp" style=""></span>mm in length, was used to obtain the histological sample. Hypoechoic lesions were identified within the atelectasis and biopsied under ultrasound guidance (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Pleural implants were also observed in 2 cases, so to complete staging, a pleural biopsy was also performed through the same access port, using a second Acecut®.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Four of the 5 patients were men. Mean age was 70 years (70<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>18.12 years). Biopsies were obtained from the right hemithorax in 3 patients, and from the left hemithorax in 2 patients. All lesions were located in the lower lobes.</p><p id="par0025" class="elsevierStylePara elsevierViewall">An adequate sample was obtained in all cases. The diagnoses from the intrapulmonary biopsy were: 4 adenocarcinomas, 2 of which were EGFR mutation-positive, and 1 epidermoid carcinoma. Pleural biopsies were positive for epidermoid carcinoma in 1 case and for adenocarcinoma in the other. Pleural biopsy and lung lesion biopsy were performed on an outpatient basis in 1 patient, and during hospital admission in all others.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Ultrasound-guided aspiration offers several advantages over CT-guided procedures, including the absence of ionizing radiation, a shorter procedure time,<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">7</span></a> a lower complication rate,<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a> and a similar diagnostic yield in peripheral lesions, although the existence of small nodular lesions seems to have less influence on ultrasound-guided biopsy,<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a> while infiltration of the chest wall can be better visualized.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a> Ultrasound aspiration is performed in real time, allowing the needle tip to be clearly visualized inside the lesion, while the use of color Doppler also minimizes the risk of puncturing intercostal arteries or other vascularized regions. In CT, in contrast, the aspiration is not performed in real time and diagnostic yield is reduced in small lesions whose position may be affected by artefacts caused by respiratory movements or association with the costal arches.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">CT, moreover, is not the ideal method for locating pulmonary nodules in pulmonary atelectasis, since it often does not properly distinguish areas suggestive of tumor involvement from the rest of the parenchyma. In our series, the simple visualization of hypo- or anechoic lesions in the pulmonary parenchyma of lungs with atelectasis on ultrasound helps differentiate lesions suggestive of malignancy from the surrounding parenchyma. In many cases, certain tools such as ultrasound contrast<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a> and color Doppler,<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a> which are useful for assessing the decrease in vascularization of the area to be biopsied, and elastography<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">14,15</span></a> help increase the diagnostic accuracy of lesions suggestive of malignancy. An additional benefit of ultrasound is that it can be performed at the patient's bedside, which is an advantage in patients with poor general condition and restricted mobility. It is important to obtain an adequate sample by core needle techniques, so that molecular receptors may be identified in some cases, guiding the use of other specific treatments that are more effective and better tolerated than conventional chemotherapy.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Although our results should be interpreted cautiously because of the small number of patients included, it should be noted that no complications occurred due to the procedure. Indeed, performing the biopsy under ultrasound guidance helps reduce the chance of accidentally puncturing areas such as vascular structures. The existence of underlying pulmonary atelectasis is likely to reduce the chances of complications such as hemorrhage or pneumothorax. The imaging technique, moreover, is harmless, because it does not emit radiation. For all these reasons, we believe that this could be a good diagnostic alternative, although more comparative studies with the techniques in current use are needed.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López González FJ, García Alfonso L, Cascón Hernández J, Ariza Prota M, Herrero Huertas J, Hermida Valverde T, et al. Biopsia de lesiones intrapulmonares en pulmones con atelectasia y derrame pleural. Arch Bronconeumol. 2021;57:438–439.</p>" ] ] "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" => 1046 "Ancho" => 1300 "Tamanyo" => 190987 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">B-mode ultrasound showing heterogeneous echostructure (black arrows) corresponding to pulmonary atelectasis with small pleural effusion (anechoic area indicated with double arrow). Hypoechoic lesion (asterisk) corresponding to the nodular lesion to be biopsied identified inside the atelectasis. The hyperechoic linear images (white arrows) correspond to core needle biopsy.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib0080" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer statistics, 2020" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.L. Siegel" 1 => "K.D. Miller" 2 => "A. Jemal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3322/caac.21590" "Revista" => array:6 [ "tituloSerie" => "CA Cancer J Clin" "fecha" => "2020" "volumen" => "70" "paginaInicial" => "7" "paginaFinal" => "30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31912902" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0085" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchoscopy for the diagnosis of peripheral lung lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.S. Dhillon" 1 => "K. Harris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.21037/jtd.2017.05.48" "Revista" => array:7 [ "tituloSerie" => "J Thorac Dis" "fecha" => "2017" "volumen" => "9" "numero" => "Suppl. 10" "paginaInicial" => "S1047" "paginaFinal" => "S1058" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29214064" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0090" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Physician-based ultrasound-guided biopsy for diagnosing pleural disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.J. Hallifax" 1 => "J.P. Corcoran" 2 => "A. Ahmed" 3 => "M. Nagendran" 4 => "H. Rostom" 5 => "N. Hassan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.14-0299" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2014" "volumen" => "146" "paginaInicial" => "1001" "paginaFinal" => "1006" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24832701" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0095" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound-guided lung biopsy in the hands of respiratory physicians: diagnostic yield and complications in 215 consecutive patients in 3 centers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.B. Laursen" 1 => "T.M.H. Naur" 2 => "U. Bodtger" 3 => "S. Colella" 4 => "M. Naqibullah" 5 => "V. Minddal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bronchol Interv Pulmonol" "fecha" => "2016" "volumen" => "23" "paginaInicial" => "220" "paginaFinal" => "228" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0100" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contrast-enhanced ultrasound for needle biopsy of central lung cancer with atelectasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Z. Lei" 1 => "J. Lou" 2 => "L. Bao" 3 => "Z. Lv" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Med Ultrason" "fecha" => "2018" "volumen" => "45" "paginaInicial" => "461" "paginaFinal" => "467" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0105" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound-guided core biopsy of thoracic tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.C. Yang" 1 => "D.B. Chang" 2 => "C.J. Yu" 3 => "Y.C. Lee" 4 => "H.D. Wu" 5 => "S.H. Kuo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/146.3.763" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1992" "volumen" => "146" "paginaInicial" => "763" "paginaFinal" => "767" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1519860" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0110" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound guidance versus CT guidance for peripheral lung biopsy: performance according to lesion size and pleural contact" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.H. Lee" 1 => "M.G. Lubner" 2 => "J.L. Hinshaw" 3 => "P.J. Pickhardt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Roentgenol" "fecha" => "2018" "volumen" => "210" "paginaInicial" => "W110" "paginaFinal" => "W117" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0115" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pleural and peripheral lung lesions: comparison of US- and CT-guided biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.M. Sconfienza" 1 => "G. Mauri" 2 => "F. Grossi" 3 => "M. Truini" 4 => "G. Serafini" 5 => "F. Sardanelli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Radiology" "fecha" => "2013" "volumen" => "266" "paginaInicial" => "930" "paginaFinal" => "935" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0120" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accuracy of CT-guided transthoracic needle biopsy of lung lesions: factors affecting diagnostic yield" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Priola" 1 => "S.M. Priola" 2 => "A. Cataldi" 3 => "L. Errico" 4 => "M. di Franco" 5 => "P. Campisi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11547-007-0212-y" "Revista" => array:6 [ "tituloSerie" => "Radiol Med" "fecha" => "2007" "volumen" => "112" "paginaInicial" => "1142" "paginaFinal" => "1159" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18074198" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0125" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intrathoracic tumors in contact with the chest wall – ultrasonographic and computed tomography comparative evaluation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Chira" 1 => "A. Chira" 2 => "P.A. Mircea" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Ultrason" "fecha" => "2012" "volumen" => "14" "paginaInicial" => "115" "paginaFinal" => "119" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22675711" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0130" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CT-guided lung biopsy: factors influencing diagnostic yield and complication rate" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.M. Anderson" 1 => "J. Murchison" 2 => "D. Patel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Radiol" "fecha" => "2003" "volumen" => "58" "paginaInicial" => "791" "paginaFinal" => "797" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0135" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contrast-enhanced ultrasound-guided transthoracic lung biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.B. Laursen" 1 => "O. Graumann" 2 => "T.V. Møller" 3 => "J.R. Davidsen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201603-0500IM" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2016" "volumen" => "194" "paginaInicial" => "e5" "paginaFinal" => "e6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27351775" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0140" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic value and safety of color doppler ultrasound-guided transthoracic core needle biopsy of thoracic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Huang" 1 => "L. Chen" 2 => "N. Xu" 3 => "L. Wang" 4 => "F. Liu" 5 => "S. He" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Biosci Rep" "fecha" => "2019" "volumen" => "39" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0145" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung transthoracic ultrasound elastography imaging and guided biopsies of subpleural cancer: a preliminary report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Sperandeo" 1 => "F.M. Trovato" 2 => "L. Dimitri" 3 => "D. Catalano" 4 => "A. Simeone" 5 => "G.F. Martines" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Radiol" "fecha" => "2015" "volumen" => "56" "paginaInicial" => "798" "paginaFinal" => "805" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0150" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound elastography of pulmonary lesions – a feasibility study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.R. Adamietz" 1 => "P.A. Fasching" 2 => "S. Jud" 3 => "R. Schulz-Wendtland" 4 => "K. Anders" 5 => "M. Uder" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0033-1355893" "Revista" => array:6 [ "tituloSerie" => "Ultraschall Med" "fecha" => "2014" "volumen" => "35" "paginaInicial" => "33" "paginaFinal" => "37" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24327473" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005700000006/v1_202106020827/S157921292100118X/v1_202106020827/en/main.assets" "Apartado" => array:4 [ "identificador" => "49861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005700000006/v1_202106020827/S157921292100118X/v1_202106020827/en/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921292100118X?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 48 | 15 | 63 |
| 2024 September | 87 | 8 | 95 |
| 2024 August | 96 | 33 | 129 |
| 2024 July | 69 | 26 | 95 |
| 2024 June | 62 | 23 | 85 |
| 2024 May | 112 | 30 | 142 |
| 2024 April | 53 | 21 | 74 |
| 2024 March | 63 | 21 | 84 |
| 2024 February | 57 | 24 | 81 |
| 2024 January | 85 | 37 | 122 |
| 2023 December | 65 | 28 | 93 |
| 2023 November | 63 | 18 | 81 |
| 2023 October | 82 | 36 | 118 |
| 2023 September | 68 | 24 | 92 |
| 2023 August | 76 | 26 | 102 |
| 2023 July | 52 | 19 | 71 |
| 2023 June | 50 | 12 | 62 |
| 2023 May | 69 | 15 | 84 |
| 2023 April | 62 | 23 | 85 |
| 2023 March | 81 | 21 | 102 |
| 2023 February | 88 | 16 | 104 |
| 2023 January | 68 | 23 | 91 |
| 2022 December | 88 | 25 | 113 |
| 2022 November | 99 | 25 | 124 |
| 2022 October | 64 | 43 | 107 |
| 2022 September | 42 | 24 | 66 |
| 2022 August | 47 | 35 | 82 |
| 2022 July | 39 | 51 | 90 |
| 2022 June | 46 | 36 | 82 |
| 2022 May | 44 | 37 | 81 |
| 2022 April | 56 | 35 | 91 |
| 2022 March | 61 | 40 | 101 |
| 2022 February | 18 | 16 | 34 |
Show all
