[Cost-effectiveness and safety of mediastinal transbronchial cryobiopsy guided by endobronchial ultrasonography (CRYO-EBUS) in 110 cases]. / Rentabilidad y seguridad de la criobiopsia transbronquial mediastínica guiada por ultrasonografía endobronquial (CRYO-EBUS) en 110 casos.

INTRODUCTION: Transbronchial needle aspiration guided by endobronchial ultrasonography (EBUSTBNA) has the disadvantage of sometimes offering samples of an unsuitable size for an accurate histo-molecular diagnosis. Transbronchial mediastinal cryobiopsy (CRYOEBUS) is a very novel and additional technique to EBUS-TBNA that allows us to obtain larger and quality samples, improving diagnostic performance. MATERIAL AND METHODS: Descriptive study of 110 patients with lesions and/or mediastinal lymphadenopathy who underwent EBUS-TBNA and CRYO-EBUS in a single procedure. Our objective was to analyze the diagnostic profitability and safety of the technique. RESULTS: CRYO-EBUS obtained samples of 0.42cm on average compared to 0.14cm obtained by EBUS-TBNA. The overall diagnostic performance of the techniques was 60% for EBUS-TBNA and 94.5% for CRYO-EBUS. Furthermore, the latter was more sensitive for the diagnosis of both malignant and benign diseases. With a very high security profile. CONCLUSIONS: The CRYO-EBUS technique is cost-effective and safe, and is superior to EBUS-TBNA. Future studies may confirm our findings.

Do Bilateral Pleural Effusions Always Have the Same Cause?

A 67-year-old man with a history of seropositive rheumatoid arthritis (RA) was admitted to the Internal Medicine ward for bilateral pleural effusion. Two years before this episode, coinciding with an exacerbation of the RA, he was incidentally diagnosed with asymptomatic left pleural effusion compatible with rheumatoid exudate, which was resolved with a tube thoracostomy. Three weeks before admission, the patient developed asthenia, orthopnoea and progressive dyspnoea. A chest x-ray revealed bilateral pleural effusion occupying the lower third of the left hemithorax and a smaller portion of the right hemithorax along with marked elevation of N-terminal fragment of pro-brain natriuretic peptide levels. The patient was admitted with a diagnosis of left-sided heart failure. Transthoracic echocardiography and cardiac catheterization confirmed the existence of ischaemic cardiomyopathy. After 2 days of diuretic treatment, the right pleural effusion resolved, but the left effusion persisted. A needle thoracentesis was performed, draining 800 ml of milky fluid compatible with rheumatoid pseudochylothorax. LEARNING POINTS: Bilateral pleural effusions nearly always have the same cause, and usually thoracentesis on only one side is needed.Rarely, however, there can be two separate causes: this is known as Contarini's syndrome.

Endometriosis pleural. A propósito de un caso / Pleural Endometriosis. A Case Report

La endometriosis extrauterina es una enfermedad poco frecuente que afecta a mujeres en edad reproductiva. La cavidad pleural es una de las localizaciones más frecuentes en este tipo de patología y es en ella donde se puede encontrar con mayor frecuencia neumotórax de repetición seguido por hemotórax. La afectación parenquimatosa, al igual que el hemotórax, es poco frecuente1. Presentamos el caso de una mujer en edad fértil con hemotórax debido a endometriosis pleural.

Extrauterine endometriosis is a rare disease that affects women of childbearing age. The pleural cavity is one of the most common locations of this type of disease and the place where recurrent pneumothorax followed by haemothorax most frequently occur. Paren chymal involvement and haemothorax aren't very frequent1. We present the case of a woman of childbearing age with haemothorax due to pleural endometriosis.

Citología pleural reumatoidea en un paciente con síndrome de Contarini / Rheumatoid Pleural Cytology in a Patient with Contarini Syndrome

La artritis reumatoide (AR) es una enfermedad autoinmune de causa desconocida y de evolución crónica que afecta fundamentalmente a las articulaciones provocando una sinovitis erosiva crónica y simétrica, presenta muchas complicaciones extraarticulares, siendo la patología pleural la complicación más frecuente entre las neumológicas. El síndrome de Contarini1 es una entidad infrecuente que consiste en la existencia concomitante de derrames pleurales bilaterales de diferente etiología. Presentamos el caso de un paciente en el que coincidieron ambas condiciones patológicas

Nueva prótesis traqueobronquial metálica autoexpandible. Indicaciones y técnica: A propósito de nuestra experiencia en tres casos / New self-expanding metal tracheobronchial prothesis. Indications and technique. Our experience in tree cases

Si bien hasta el momento los stents más utilizados en vía aérea son los de silicona, desde hace un tiempo se utilizan los stents metálicos. Su indicación principal es la estenosis neoplásica maligna traqueal o bronquial. Hemos tenido la oportunidad de colocar un nuevo tipo de SMA en dos indicaciones distintas a la mencionada, por lo que nos parece interesante la descripción de los casos.

Although the most commonly used stents in the air are silicone, stents have been used for some time. Its main indication is malignant tracheal or bronchial neoplastic stenosis. We have had the opportunity to place a new type of SMA in two different indications to the mentioned one, reason why we consider interesting the description of the cases.