TABLE 3.
Follow-up on Nondiagnostic Biopsies
| Patient # | Biopsy Results | Additional Procedures Performed After Nondiagnostic Bronchoscopy | Nodule Size (mm) | Location of the Nodule With Respect to Lung Parenchyma | Location | Lesion Categorized as | Follow-up and Relevant Past Medical History |
|---|---|---|---|---|---|---|---|
| 1 | Reactive cells | None | 9 | Medial one third | LUL | NA Need for follow-up | 3 and 12 mo follow-up CT scans demonstrated stable 9 mm nodule |
| 2 | Nondiagnostic | Yes | 14 | Central one third | LUL | False negative | 3 mo follow-up CT chest showed increased size nodule in LUL, leading to repeat RAB with EBUS, consistent with metastatic colon carcinoma |
| 3 | Nondiagnostic | No | 28 | Lateral one third | RML | Labeled as indeterminate at the time of index procedure | 12 mo follow-up CT chest showed decreasing in size of the lung nodule to 14 mm and more ground glass in nature compared with prior CT chest |
| 4 | Atypical cells | Yes | 16 | Central one third | LUL | False negative | After nondiagnostic RAB, the patient underwent CT-guided percutaneous biopsy which was nondiagnostic. Given clinical concern for malignancy, the patient underwent surgical wedge resection—consistent with squamous cell carcinoma |
| 5 | Non-necrotizing granulomatous inflammation (NNGI) | No | 11 | Lateral one third | RUL | Benign | 3 mo CT follow-up studies demonstrated reduction in nodule size with resolution of mediastinal lymphadenopathy. Linear EBUS biopsies consistent with NNGI in 3/3 mediastinal lymph node stations |
| 6 | Nondiagnostic | Yes | 19 | Peripheral one third | LLL | Need further follow-up | RAB biopsies consistent with reactive cellular changes. This nodule was rebiopsied by TTNA, demonstrated a fibroelastotic scar of apical cap type |
| 7 | Nondiagnostic | No | 15 45 | LLL LUL | Benign | Targeted LLL lesion had resolved at the time of procedure. Previously radiated area at LUL was biopsied and demonstrated postradiation changes |
CT indicates computed tomography; EBUS, endobronchial ultrasound; LLL, left lower lobe; LUL, left upper lobe; NA, not available; RAB, robotic-assisted bronchoscopy; RML, right middle lobe; RUL, right upper lobe; TTNA, transthoracic needle aspiration.