Skip to content
2000
Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603

Abstract

Introduction

The current article presents a clinical case of ultrasound controlled transthoracic tru-cut needle biopsy of a small metastatic lesion in the left lung, performed with contrast-enhanced ultrasonography (CEUS). The following case demonstrates a real-time interventional manipulation of a very small lesion, which was done under local anesthesia, with a minimal invasion to the patient.

Case Presentation

A 72-year-old woman is presented, hospitalized for a left-sided pleural effusion with bilateral, multiple nodulеs of different sizes in the lungs. Thoracentesis revealed data for atypical cells in the pleural fluid. The CT scan suspected a probable neoplastic process, but the subsequently performed fiberbronchoscopy couldn’t prove the existence of the same. The final diagnosis was established after ultrasound controlled transthoracic tru-cut needle biopsy of a pulmonary lesion with the application of a contrast medium.

Conclusion

The CEUS allows precise detection of the metastatic area because of its unique perfusion characteristics and ability to remain hypocontrasted after the application of the contrast medium sulfur hexafluoride. The persistence of a concomitant left-sided pleural effusion is used as an ultrasound window during the performance of the manipulation, with the successful verification of the pathology as primary pulmonary adenocarcinoma. By the application of this minimally invasive manipulation, an accurate final histological result was obtained.

This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Loading

Article metrics loading...

/content/journals/cmir/10.2174/1573405620666230801110930
2024-01-01
2025-09-11
Loading full text...

Full text loading...

/deliver/fulltext/cmir/20/1/CMIR-20-E010823219333.html?itemId=/content/journals/cmir/10.2174/1573405620666230801110930&mimeType=html&fmt=ahah

References

  1. PiscagliaF. NolsøeC. DietrichC. CosgroveD. GiljaO. Bachmann NielsenM. AlbrechtT. BarozziL. BertolottoM. CatalanoO. ClaudonM. ClevertD. CorreasJ. D’OnofrioM. DrudiF. EydingJ. GiovanniniM. HockeM. IgneeA. JungE. KlauserA. LassauN. LeenE. MathisG. SaftoiuA. SeidelG. SidhuP. HaarG. TimmermanD. WeskottH. The EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS): Update 2011 on non-hepatic applications.Ultraschall Med.2012331335910.1055/s‑0031‑128167621874631
    [Google Scholar]
  2. QuaiaE. Assessment of tissue perfusion by contrast-enhanced ultrasound.Eur. Radiol.201121360461510.1007/s00330‑010‑1965‑620927527
    [Google Scholar]
  3. GörgC. BertT. KringR. Contrast-enhanced sonography of the lung for differential diagnosis of atelectasis.J. Ultrasound Med.2006251353910.7863/jum.2006.25.1.3516371553
    [Google Scholar]
  4. GörgC. KringR. BertT. Transcutaneous contrast-enhanced sonography of pleural-based pulmonary lesions.Eur. J. Radiol.200764221322110.1016/j.ejrad.2007.06.03717904322
    [Google Scholar]
  5. PetkovR. YamakovaY. PetkovaE. Transthoracic contrast-enhanced ultrasound examination of pulmonary lesions.Diagnostic and Therapeutic Ultrasound201213643
    [Google Scholar]
  6. LindeH.N. HollandA. GreeneB.H. GörgC. [Contrast-enhancend sonography (CEUS) in pneumonia: Typical patterns and clinical value: A retrospective study on n = 50 patients].Ultraschall Med.201233214615110.1055/s‑0031‑127328021630185
    [Google Scholar]
  7. Go¨rgC. BertT. Go¨rgK. Contrast-enhanced sonography for differential diagnosis of pleurisy and focal pleural lesions of unknown cause.Chest200512863894389910.1378/chest.128.6.389416354860
    [Google Scholar]
  8. ClaudonM. CosgroveD. AlbrechtT. BolondiL. BosioM. CalliadaF. CorreasJ.M. DargeK. DietrichC. D’OnofrioM. EvansD. FiliceC. GreinerL. JägerK. JongN. LeenE. LencioniR. LindsellD. MarteganiA. MeairsS. NolsøeC. PiscagliaF. RicciP. SeidelG. SkjoldbyeB. SolbiatiL. ThoreliusL. TranquartF. WeskottH. WhittinghamT. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS): Update 2008.Ultraschall Med.2008291284410.1055/s‑2007‑96378518270887
    [Google Scholar]
  9. SidhuP. CantisaniV. DietrichC. GiljaO. SaftoiuA. BartelsE. BertolottoM. CalliadaF. ClevertD.A. CosgroveD. DeganelloA. D’OnofrioM. DrudiF. FreemanS. HarveyC. JenssenC. JungE.M. KlauserA. LassauN. MeloniM. LeenE. NicolauC. NolsoeC. PiscagliaF. PradaF. ProschH. RadzinaM. SavelliL. WeskottH.P. WijkstraH. The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: Update 2017 (Long Version).Ultraschall Med.2018392e2e4410.1055/a‑0586‑110729510439
    [Google Scholar]
  10. GörgC. KringR. BertT. Transcutaneous contrast-enhanced sonography of peripheral lung lesions.AJR Am. J. Roentgenol.20061874W420W42910.2214/AJR.05.089016985116
    [Google Scholar]
  11. SartoriS. PostorivoS. VeceF.D. ErmiliF. TassinariD. TombesiP. Contrast-enhanced ultrasonography in peripheral lung consolidations: What’s its actual role?World J. Radiol.201351037238010.4329/wjr.v5.i10.37224179632
    [Google Scholar]
  12. TrevisaniL. SartoriS. PutinatiS. AbbascianoV. CerviP.M. Needle aspiration biopsy and ultrasonic guidance.Chest1994106265010.1378/chest.106.2.6507774373
    [Google Scholar]
  13. SagarP. GulatiM. GuptaS.K. GuptaS. ShankarS. JoshiK. JindalS.K. SuriS. Ultrasound-guided transthoracic co-axial biopsy of thoracic mass lesions.Acta Radiol.200041652953210.1080/02841850012734611711092470
    [Google Scholar]
  14. SartoriS. NielsenI. TrevisaniL. TombesiP. CeccottiP. AbbascianoV. Contrast-enhanced sonography as guidance for transthoracic biopsy of a peripheral lung lesion with large necrotic areas.J. Ultrasound Med.200423113313610.7863/jum.2004.23.1.13314756362
    [Google Scholar]
  15. MihalovaT. Ultrasound examination in the diagnosis of pleural diseases.PhD dissertation thesis. Medical University - Sofia2021
    [Google Scholar]
/content/journals/cmir/10.2174/1573405620666230801110930
Loading
/content/journals/cmir/10.2174/1573405620666230801110930
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test