 |
Vol.41 No.2 contents | Japanese/English |
 | Full Text of PDF (180K) Article in Japanese |
- Case Report -
Preoperative Marking by Bronchoscopic Dye Injection for a Non-palpable Small Pulmonary Lesion With Ground-Glass Attenuation: A Case Report
Toshihiko Sakamoto, Noriaki Tsubota, Hidehito Matsuoka, Yoshiki Takada, Masahiro Endoh and Yoshikazu KotaniDepartment of General Thoracic Surgery and Radiology, Hyogo Medical Center for Adults, Akashi, Japan
Background: A new marking method via a transbronchial approach has been developed to localize small pulmonary nodules situated deeply from the visceral pleura. Case: A 45-year-old woman was admitted for further evaluation and treatment of a small lung nodule. High-resolution chest CT showed a nodule of 15 mm in diameter with ground-glass attenuation in right S3a, that is the lateral subsegment of the anterior segment. Bronchoscopic brushing cytology revealed atypical adenomatous hyperplasia or bronchiolo-alveolar carcinoma. Inasmuch as the tumor was thought not to be visible or palpable during operation, preoperative marking by bronchoscopic dye injection was performed the day before operation. On confirming that the tip of the sheath catheter passed the tumor and reached the visceral pleura by CT fluoroscopy, 0.5 mL of indigo carmine was injected through the bronchoscope into the lung parenchyma just under the visceral pleura. There were no complications related to the procedure. During the operation the dye marking was seen clearly. Segmental resection of S2b + S3a was performed through access thoracotomy. The marking located the tumor precisely. Pathological examination revealed localized bronchioloalveolar carcinoma with foci of alveolar structural collapse. Conclusion: This technique proved to be a safe, reliable, and convenient marking method when video-assisted thoracic surgery (VATS) would be performed.
key words: Marking, Lung nodules, VATS, Transbronchial approach
Received: November 30, 2000
Accepted: January 18, 2001
JJLC 41 (2): 147-149, 2001
