Endobronchial lesion in an adolescent with hemoptysis biopsy or not to biopsy?

Pediatr Pulmonol. 2023 Apr;58(4):1289-1291. doi: 10.1002/ppul.26329. Epub 2023 Feb 2.

Abstract

An 11-year-old girl was brought with complaints of recurrent massive hemoptysis. A computerized tomography (CT) of the chest showed ground glass opacities on the right lower lobe, and a CT angiography showed hypertrophied right pulmonary artery. Flexible bronchoscopy revealed a sessile friable lesion in the right lower lobe, raising suspicion of either a tumor or a vascular malformation. An endobronchial ultrasound (EBUS) revealed a cystic lesion in the submucous plane, with vascularity noted on Doppler mode. This confirmed the diagnosis of bronchial Dieulafoy disease. A bronchial angiography revealed a vascular malformation overlying the lesion with a bronchopulmonary shunt, which was ligated. This case demonstrates the importance of EBUS in endobronchial lesions, to avoid biopsy of a vascular malformation.

Keywords: EBUS; bronchial Dieulafoy disease; endobronchial lesion; endobronchoal ultrasound; hemoptysis.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Biopsy
  • Bronchial Diseases* / diagnostic imaging
  • Bronchoscopy
  • Child
  • Female
  • Hemoptysis / diagnosis
  • Hemoptysis / etiology
  • Humans
  • Vascular Diseases*
  • Vascular Malformations*