Radiological analysis of solitary cavitary lesions of the lung: Differentiation between lung cancer and tuberculosis

Lee, K S; Park, K S; Choi, Wonil; Yoon, Yup; Lim, Jia Hui

doi:10.3348/jkrs.1989.25.3.410

Cited by 2 publications

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“…Kim et al [ 29 ]. reported that the presence of a satellite centrilobular nodule and a difference in HUs of less than 20 between pre- and post-enhancement images were useful predictors for benign nodules rather than malignant lesions, whereas Lee et al [ 30 ]. identified that the presence of concentric cavitation could suggest the possibility of tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe endobronchial ultrasound

et al. 2021

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Background Bronchoscopy using radial probe endobronchial ultrasound (EBUS) is performed when a peripheral lung lesion (PLL) is suspected to be malignant. However, pulmonary tuberculosis is diagnosed in some patients, and healthcare workers could therefore be exposed to tuberculosis if sufficient precautions are not taken. In this study, we examined the proportion of and factors associated with unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe EBUS. Methods This retrospective study included 970 patients who received bronchoscopy using radial probe EBUS between December 2015 and November 2018. Clinical, histological, radiological, and microbiological data were reviewed. Results Pulmonary tuberculosis was diagnosed in 31 patients (3.2%) during bronchoscopy using radial probe EBUS. Patients with a lower age were significantly more likely to be diagnosed with tuberculosis than elderly patients (odds ratio [OR], 0.951; 95% confidence interval [CI], 0.924–0.978; P = 0.001). Among the various CT findings, a low HUs difference between pre- and post-enhanced CT (OR, 0.976; 95% CI, 0.955–0.996; P = 0.022), the presence of concentric cavitation (OR, 5.211; 95% CI, 1.447–18.759; P = 0.012), and the presence of satellite centrilobular nodules (OR, 22.925; 95% CI, 10.556–49.785; P < 0.001) were independently associated with diagnosis of tuberculosis. Conclusions The proportion of unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe EBUS was 3.2%. A higher risk was independently associated with a younger age and CT findings of a small difference in HUs between pre- and post-enhancement images, concentric cavitation, and the presence of a satellite centrilobular nodule.

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Section: Discussionmentioning

confidence: 99%

Unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe endobronchial ultrasound

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Kim et al [29]. reported that the presence of a satellite centrilobular nodule and a difference in HUs of less than 20 between pre-and post-enhancement images were useful predictors for benign nodules rather than malignant lesions, whereas Lee et al [30]. identi ed that the presence of concentric cavitation could suggest the possibility of tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Unexpected Diagnosis of Pulmonary Tuberculosis During Bronchoscopy Using Radial Probe Endobronchial Ultrasound

Chung

Bae

Kim

et al. 2020

Preprint

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Background: Bronchoscopy using radial probe endobronchial ultrasound (EBUS) is performed when a peripheral lung lesion (PLL) is suspected to be malignant. However, pulmonary tuberculosis is unexpectedly diagnosed in some patients, and healthcare workers could therefore be exposed to tuberculosis if sufficient precautions are not taken. In this study, we examined the incidence of and factors associated with unexpected diagnosis of pulmonary tuberculosis during bronchoscopy using radial probe EBUS.Methods: This retrospective study included 970 patients who received bronchoscopy using radial probe EBUS between December 2015 and November 2018. Clinical, histological, radiological, and microbiological data were reviewed.Results: Pulmonary tuberculosis was unexpectedly diagnosed in 31 patients (3.2%) during bronchoscopy using radial probe EBUS. Patients with a lower age were significantly more likely to be diagnosed with tuberculosis than elderly patients (odds ratio [OR], 0.951; 95% confidence interval [CI], 0.924–0.978; P = 0.001). Among the various CT findings, a low HUs difference between pre- and post-enhanced CT (OR, 0.976; 95% CI, 0.955–0.996; P = 0.022), the presence of concentric cavitation (OR, 5.211; 95% CI, 1.447–18.759; P = 0.012), and the presence of satellite centrilobular nodules (OR, 22.925; 95% CI, 10.556–49.785; P < 0.001) were independently associated with unexpected diagnosis of tuberculosis.Conclusions: The risk of healthcare workers being exposed to Mycobacterium tuberculosis during bronchoscopy using radial probe EBUS has been underestimated. Our results suggest that healthcare workers in the bronchoscopy suite should consider high-grade respiratory protection when examining patients with risk factors for an unexpected diagnosis of pulmonary tuberculosis.

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Radiological analysis of solitary cavitary lesions of the lung: Differentiation between lung cancer and tuberculosis

Cited by 2 publications

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Unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe endobronchial ultrasound

Unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe endobronchial ultrasound

Unexpected Diagnosis of Pulmonary Tuberculosis During Bronchoscopy Using Radial Probe Endobronchial Ultrasound

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