Bronchoscopy was performed under computed tomography (CT) guidance using an ultrathin fiberscope in a patient with a fluoroscopically invisible lesion that was visualized by CT in the right S and with poor pulmonary function. Under local anesthesia, the ultrathin fiberscope (3 mm in diameter) was inserted close to the lesion (1.5 mm in diameter) under direct visual guidance, and a brush was inserted into the lesion under CT guidance. Cytologic specimens obtained by the brush and washing revealed adenocarcinoma. This is the first report of CT-guided bronchoscopy, which is a new examination method for peripheral small lung lesions and is a less invasive examination than either endoscopic examination with a conventional bronchoscope or open lung biopsy, especially for those with poor pulmonary function.
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