Rigid bronchoscopy is a common procedure for central airway obstructions (CAO). Many patients with advanced lesions causing CAO have tenuous, positionally dependent respiratory status which requires additional procedural considerations. This case report describes a 57-year-old man with high grade epithelioid angiosarcoma of the right lung and pleura who underwent placement of a tracheal stent by rigid bronchoscopy in the novel procedural conditions of right lateral decubitus, semi-sitting position with dexmedetomidine, midazolam, and propofol for moderate sedation.
View Article and Find Full Text PDFWe describe an unusual case of combined small cell lung carcinoma (SCLC) with a heterologous sarcomatous component of rhabdomyosarcoma in a 61-year-old male smoker. The diagnosis was made using endobronchial ultrasound (EBUS)-guided fine needle aspiration and biopsy. This report highlights the challenges of diagnosing small round blue cell tumors in limited material and the importance of ancillary testing.
View Article and Find Full Text PDFJ Bronchology Interv Pulmonol
July 2023
Extracorporeal photopheresis (ECP) is a commonly used treatment for severe graft-versus-host-disease (GVHD). We sought to evaluate the effects of ECP over a prolonged period on forced expiratory volume in 1 s (FEV1) in patients with pulmonary GVHD. We identified eight patients who developed new airflow obstruction following allogeneic stem cell transplantation and a substantial decline in FEV1 despite receiving corticosteroids and standard therapy for pulmonary GVHD.
View Article and Find Full Text PDFDiagnosis of invasive pulmonary aspergillosis (IPA) is a challenging process in immunocompromised patients. Galactomannan (GM) antigen detection in bronchoalveolar lavage (BAL) fluid is a method to detect IPA with improved sensitivity over conventional studies. We sought to determine the diagnostic yield of BAL GM assay in a diverse population of immunocompromised patients.
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