Page 62 - ECBIP 2021_Program

6th European Congress ECBIP 15 - 17
Book of Abstracts
for Bronchology and
Interventional Pulmonology ATHENS - GREECE 2021
OCTOBER
MODERATED e-POSTER SESSION 05:
Imaging,Guiding,Training and Navigation modalities
THE ROLE OF NARROW-BAND IMAGING IN FLEXIBLE BRONCOSCOPY: A CASE REPORT
Joana Da Silva Arana Fonseca Ribeiro1, Rebeca Martins Natal1, Gonçalo Samouco1, Rita Matos Gomes1,2, Luís Vaz Rodrigues1,2
1 Pulmonary Medicine, Unidade Local De Saúde Da Guarda, E.P.E., Guarda, Portugal 2 Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
PP32
Introduction: Narrow-band Imaging (NBI) bronchoscopy enhances surface structure and vascular anomalies/patterns in the superficial mucosa, some of them non-visible through conventional white light.
Methods/Results: A 61-year-old female non-smoker with no significant past medical or exposure history was presented to a the pulmonology outpatient department with non-productive chronic cough. Respiratory examination, blood and pulmonary function tests did not reveal any alteration. Chest radiograph did not expose any relevant abnormality, although chest computed tomography scan showed a small area of ground-glass opacity on posterior segment of
the right upper lobe of the lung. A flexible bronchoscopy was performed, without revealing any abnormalities in the mucosa when inspected with conventional white-light (Figure 1A), although, when inspect with NBI, a lesion with dotted blood vessel pattern was evident on the lateral side of right B2 (Figure 1B). Bronchial biopsies were obtained at this location and revealed the presence of pavement metaplasia. Flexible bronchoscopy was repeated 3 months later, which showed decreased lesion size with the same pattern, only visible with NBI, surrounded by scarred mucosa. A new histological re-characterization was performed by bronchial biopsy and tangential Argon Plasma Coagulation (APC) was applied to the lesion (2 applications of 25 watts, 5 to 6 seconds) ensuring coverage of the lesion and biopsied area. Flexible bronchoscopy reevaluation was repeated until 6 months later with mild mucosal thickening with scar appearance in the APC application area without signs of suspicious lesion on conventional white-light (Figure 2A) and NBI inspection (Figure 2B).
Conclusion: NBI has the potential to improve the sensitivity for detecting and characterizing dysplastic and neoplastic lesions of bronchial mucosa that can remain underappreciated in simple white-light bronchoscopy, as demonstrated in this clinical case.
Figure 1: Lesion with dotted blood vessel pattern on the lateral side of right B2 underappreciated using conventional white-light (Figure 1A), but evident under Narrow-Band Imaging inspection (Figure 1B).
Figure 2: Mild mucosa thickening with scar appearance in Argon Plasma Coagulation application area without suspicious lesion on conventional white-light (Figure 2A) and Narrow-Band Imaging inspections (Figure 1A) at the 6th month reevaluation.
62 6th European Congress for Bronchology and Interventional Pulmonology