[Complicated hematomediastinum in a 76-year-old patient after performing an endosonographically guided transbronchial cryobiopsy (EBUS-TBCB) with suspected lymphoma]. / Komplikatives Hämatomediastinum einer 76-jährigen Patientin nach Durchführung einer endosonografisch gesteuerten transbronchialen Kryobiopsie (EBUS-TBKB) bei Verdacht einer Lymphomerkrankung.

We present the case of a patient with severe complications from mediastinal bleeding after endosonographically guided transbronchial cryobiopsy (EBUS-TBKB) with suspected advanced lymphoma. The EBUS-TBKB is a new effective examination method in interventional pneumology for the diagnosis of diseases with mediastinal lymph node enlargement and intrathoracic tumors, with which large tissue cylinders in the mediastinum can be obtained. Due to the high diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the clarification of lymphadenopathy, the examination should not be carried out as a routine application. Indications for a primary EBUS-TBKB arise when there is a suspicion of intrathoracic malignant lymphomas or other rare tumors in which extensive unfragmented tissue material is required for diagnosis. A rare complication that has not yet been described in the literature is a hematomediastinum, so that a careful risk assessment of possible bleeding complications should be carried out before intervention and the more invasive mediastinoscopy can be a safer examination method.

[The Importance of Electromagnetic Navigation Bronchoscopy in the Clarification of Pulmonary Nodules]. / Stellenwert der elektromagnetischen Navigationsbronchoskopie bei der Abklärung pulmonaler Rundherde.

Electromagnetic navigation bronchoscopy (ENB) is a very helpful examination for clarifying pulmonary nodules (PDs). The advantages are the low complication rate, avoiding the dangers of punctures in several areas of the lungs during an examination under general anesthesia and no radiation exposure. If malignancy is confirmed, PDs are curatively treatable as they are often early-stage cancers and, in case the disease is benign, it is treatable as other infectious diseases. With experience and routine use, the ENB procedure can contribute to the successful diagnosis of peripheral lesions (at least 1.5 cm in size) in about 75 % of cases. Due to the increase in CT chest examinations and the aging population, clarification of patients with PD is becoming increasingly important in lung clinics. The ENB should therefore develop into a routine examination procedure in interventional pulmonology in addition to the now indispensable endobronchial ultrasound examination. Unfortunately, the ENB is not yet mapped in the DRG system in a cost-relevant manner.