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array:23 [ "pii" => "S0300289624001224" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.04.014" "estado" => "S300" "fechaPublicacion" => "2024-08-01" "aid" => "3542" "copyright" => "SEPAR" "copyrightAnyo" => "2024" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:531-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0300289624001236" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.04.015" "estado" => "S300" "fechaPublicacion" => "2024-08-01" "aid" => "3543" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:533-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Letter</span>" "titulo" => "Successful Conservative Treatment in a Long Iatrogenic Rupture of the Membranous Tracheal Wall" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "533" "paginaFinal" => "534" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 464 "Ancho" => 1340 "Tamanyo" => 91603 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) 3<span class="elsevierStyleHsp" style=""></span>cm longitudinal laceration of the tracheal posterior wall, up to the submucosa; (B) bronchofibroscopy at 4 days; signs of healing; (C) bronchofibroscopy at 1 month; signs of granulation tissue.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maria Bragança, Júlio Semedo, Fernanda Paula" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Maria" "apellidos" => "Bragança" ] 1 => array:2 [ "nombre" => "Júlio" "apellidos" => "Semedo" ] 2 => array:2 [ "nombre" => "Fernanda" "apellidos" => "Paula" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001236?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000008/v1_202408020536/S0300289624001236/v1_202408020536/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289624001182" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.04.010" "estado" => "S300" "fechaPublicacion" => "2024-08-01" "aid" => "3538" "copyright" => "The Author(s)" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:529-30" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Letter</span>" "titulo" => "Doctor, Why is my Lung Gurgling?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "529" "paginaFinal" => "530" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 945 "Ancho" => 905 "Tamanyo" => 175998 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Images A–C belong to the 2023 Computed Tomography (CT) scan in the coronal, sagittal and axial planes, respectively. Herniation of the abdominal viscera into the left hemithorax is evident, with the following sac contents: ventral portion of a pancreas bifidum, left kidney, mesenteric root, transverse colon, ascending colon, cecum, appendix, a major portion of the stomach as well as the angle of Treitz and the entire small intestine. The displacement of the mediastinum toward the right has led to compression of not just the left but also the right lung, which is consistent with the patient's worsening dyspnea. Image D corresponds to the Gore-Tex Dual mesh dynamic patch, 20<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>cm in diameter, used in this case. Its dimensions were revised again prior to placement to ensure complete coverage of the defect. Image E was taken just moments after the end of the placement of the patch with 11 manually tailored Gore-Tex buttons additionally sutured to provide structural support to the prosthesis.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniel Sanchez-Osorio, Aura Ortega-Claici, Nicolás Martínez-Gómez, María Rodríguez-Pérez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Sanchez-Osorio" ] 1 => array:2 [ "nombre" => "Aura" "apellidos" => "Ortega-Claici" ] 2 => array:2 [ "nombre" => "Nicolás" "apellidos" => "Martínez-Gómez" ] 3 => array:2 [ "nombre" => "María" "apellidos" => "Rodríguez-Pérez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001182?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000008/v1_202408020536/S0300289624001182/v1_202408020536/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Letter</span>" "titulo" => "Primary Pulmonary Artery Sarcoma: A Rare Tumor Diagnosed by EBUS Guided Mediastinal Cryobiopsy" "tieneTextoCompleto" => true "saludo" => "To the Director," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "531" "paginaFinal" => "532" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Selene Cuenca Peris, Mónica Bauza, Andrés Briones Gómez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Selene" "apellidos" => "Cuenca Peris" "email" => array:1 [ 0 => "selenecp@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Mónica" "apellidos" => "Bauza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Andrés" "apellidos" => "Briones Gómez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Endoscopias Respiratorias y Neumología Intervencionista, Hospital Universitario y Politécnico La Fe, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Pathology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 843 "Ancho" => 2000 "Tamanyo" => 249830 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(1a) Contrast-enhanced CT reveals a mild enhanced mass in the left pulmonary artery. (1b) 18F-fluorodeoxyglucose (FDG) positron emission tomography with integrated CT shows a positive uptake of FDG to the pulmonary artery mass. (2) Ultrasound image of fine needle (2a) and cryoprobe (2b) in the middle of the mass. (3) Hemtoxylin–eosin: atypical spindle cells with irregular, pleomorphic, large spindle-shaped nuclei, with elongated cytoplasms (3a,3b). Immunocytochemical study: MDM2++ positive tumor cells (3c) and negative for actine (3d).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report a case of a 64-year-old man diagnosed with pulmonary thromboembolism 10 months ago with radiological progression despite anticoagulant treatment. The patient presents dyspnea and chest pain. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET-CT) showed a hypermetabolic intraluminal solid lesion in the left main pulmonary artery (Suv 8.3) with heterogeneous contrast enhancement and extension to the interlobar artery and upper lobe artery (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Echobronchoscopy showed the occupation of the pulmonary artery by an isoechogenic material with anechoic irregular areas. Elastography shows a predominantly rigid lesion. We performed an Endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA) with a 21G needle and EBUS guided mediastinal cryobiopsy (EBUS-MCB) with a 1.1<span class="elsevierStyleHsp" style=""></span>mm cryoprobe (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 2</a>). There weren’t relevant complications, just a little bleeding. The pathological result was intimal sarcoma of the pulmonary artery (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 3</a>). The patient was treated with left pneumonectomy and resection of the sarcoma on the left pulmonary artery.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Pulmonary artery sarcoma (PAS) is a rare entity with an estimated global incidence of 0.001–0.03%.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Histopathology reveals mesenchymal origin. More than half of the patients are misdiagnosed as pulmonary thromboembolism because symptoms (predominantly dyspnea, cough, and chest pain) and radiological images in chest angiotomography are very similar.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> PAS should be suspected in patients with chronic pulmonary thromboembolism with right heart failure due to pulmonary hypertension that doesn’t improve despite anticoagulant treatment<span class="elsevierStyleInf">.</span> In these cases, PET-CT can differentiate the two entities based on the maximal standardized uptake value (SUVmax) that is significantly higher in pulmonary artery sarcoma. The diagnosis is histopathological.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Surgical resection is considered the best option for treatment and adjuvant chemotherapy and radiation therapy may extend survival in some cases.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The literature describes different alternatives to achieve sample for histopathological diagnosis: mediastinoscopy, EBUS-TBNA and Endovascular catheter Biopsy.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,3</span></a> In our case, we described the first case diagnosed using EBUS-MCB. This is a novel, minimally invasive technique with few complications.</p><p id="par0020" class="elsevierStylePara elsevierViewall">EBUS allows better visualization of the tumor and vascular flow via Doppler ultrasonography but cytology obtained by TBNA shows limited percentage of viable tumor components. For that reason, MCB is a complementary procedure that allows to obtain large mediastinal samples with preserved tissue architecture for a better comprehensive morphophysiological and molecular diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a> The technique consists of applying cold with the cryoprobe (3–4<span class="elsevierStyleHsp" style=""></span>s).</p><p id="par0025" class="elsevierStylePara elsevierViewall">EBUS-MCB did not generate any relevant complications. Most frequent is light bleeding resulting from the previous puncture with the aspiration needle used in EBUS-TBNA. Other less frequent complications such as pneumothorax, mediastinitis, pneumomediastinum, and hemomediastinum, have been described in a small percentage of cases.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">If we compare EBUS-MCB with the methods used for the diagnosis of PAS, it is a cost-effective, fast, and minimally invasive technique, with few complications. Moreover, we obtain a larger sample than with EBUS-TBNA, which avoids the need for re-biopsies. Therefore, if pulmonary artery sarcoma is suspected in a location accessible to the EBUS, it could be considered as a diagnostic option.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors state that they have no conflict of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interests" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 843 "Ancho" => 2000 "Tamanyo" => 249830 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(1a) Contrast-enhanced CT reveals a mild enhanced mass in the left pulmonary artery. (1b) 18F-fluorodeoxyglucose (FDG) positron emission tomography with integrated CT shows a positive uptake of FDG to the pulmonary artery mass. (2) Ultrasound image of fine needle (2a) and cryoprobe (2b) in the middle of the mass. (3) Hemtoxylin–eosin: atypical spindle cells with irregular, pleomorphic, large spindle-shaped nuclei, with elongated cytoplasms (3a,3b). Immunocytochemical study: MDM2++ positive tumor cells (3c) and negative for actine (3d).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comprehensive review on the diagnosis and management of intimal sarcoma of the pulmonary artery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Assi" 1 => "J. Kattan" 2 => "E. Rassy" 3 => "T. Moussa" 4 => "H. Nassereddine" 5 => "C. Honore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.critrevonc.2020.102889" "Revista" => array:4 [ "tituloSerie" => "Crit Rev Oncol Hematol" "fecha" => "2020" "volumen" => "147" "paginaInicial" => "102889" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical features and outcomes of pulmonary artery sarcoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Li" 1 => "L. Liu" 2 => "L.X. Song" 3 => "Y. Zhang" 4 => "Y. Liu" 5 => "S. Gu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.hlc.2021.06.448" "Revista" => array:6 [ "tituloSerie" => "Heart Lung Circ" "fecha" => "2022" "volumen" => "31" "paginaInicial" => "230" "paginaFinal" => "238" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34417115" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endovascular biopsy for pulmonary artery sarcoma mimicking pulmonary embolism" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.K. Yeh" 1 => "S.Y. Hsiao" 2 => "J.N. Roan" 3 => "Y.P. Chen" 4 => "P.Y. Liu" 5 => "H.Y. Chang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.6515/ACS. 202307_39(4).20230306C" "Revista" => array:5 [ "tituloSerie" => "Acta Cardiol Sin" "fecha" => "2023" "volumen" => "39" "paginaInicial" => "658" "paginaFinal" => "662" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is the diagnostic yield of mediastinal lymph node cryobiopsy (cryoEBUS) better for diagnosing mediastinal node involvement compared to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)? A systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Botana-Rial" 1 => "I. Lojo-Rodríguez" 2 => "V. Leiro-Fernández" 3 => "C. Ramos-Hernández" 4 => "A. González-Montaos" 5 => "L. Pazos-Area" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2023.107389" "Revista" => array:5 [ "tituloSerie" => "Respir Med" "fecha" => "2023" "volumen" => "218" "paginaInicial" => "107389" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37579981" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transbronchial needle aspiration combined with cryobiopsy in the diagnosis of mediastinal diseases: a multicentre, open-label, randomised trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Fan" 1 => "A.M. Zhang" 2 => "X.L. Wu" 3 => "K. Kontogianni" 4 => "K. Sun" 5 => "W. Fu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2213-2600(22)00392-7" "Revista" => array:6 [ "tituloSerie" => "Lancet Respir Med" "fecha" => "2023" "volumen" => "11" "paginaInicial" => "256" "paginaFinal" => "264" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36279880" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000006000000008/v1_202408020536/S0300289624001224/v1_202408020536/en/main.assets" "Apartado" => array:4 [ "identificador" => "97872" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000006000000008/v1_202408020536/S0300289624001224/v1_202408020536/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001224?idApp=UINPBA00003Z" ]
