Role of Radial Probe Ultrasonography and Transbronchial Biopsy in Differentiating Lung Tumors from Other Lung Pathologies in Patients with Indeterminate CT Findings

Lung cancer and other pathologies, can present with similar clinical and radiological features. This can lead to misdiagnosis of lung cancer in patients with suspected differential diagnoses on CT scans. Bronchoscopy with transbronchial biopsy (TBB with forceps or crybiopsy), aided by radial probe ultrasonography (R-EBUS), can avoid delayed lung cancer diagnosis and late treatment with poorer outcomes.

Methods: We present a single-center retrospective study of 12 patients with suspected CT scan findings for primary tuberculosis, granuloma-sarcoidosis, or vessel malformation with secondary suspicion of tumor. Patients underwent further bronchoscopic evaluation using R-EBUS performed by an interventional pulmonologist.

Results: Among all patients, six were diagnosed with lung tumors (1 patient adenocarcinoma, 1 patient small cell lung carcinoma, 2 patients with typical carcinoid, 2 patient with atypical carcinoid), two diagnosed with TBC in samples from TBB, 1 patient with COP, 1 patient with granuloma, and two patients had a biopsy negative for malignant cells or granuloma.

Conclusion: Performing bronchoscopy with primary transbronchial biopsy in addition to bronchoalveolar lavage for differential diagnosis, confirmed by R-EBUS in cases with suspected tuberculosis, granuloma, or vessel malformations can avoid delayed cancer diagnosis and treatment, ultimately leading to better outcomes.

Publication History

Article published online:
18 March 2025