RESUMO
The diagnosis of intrathoracic non-tuberculous mycobacteriosis (NTM) is challenging. We report a case of a pediatric pulmonary NTM with endobronchial lesion and lymphadenitis in a child with HIV infection diagnosed by bronchoscopic biopsy, EBUS-TBNA and probe-based confocal laser endomicroscopy (pCLE). The pCLE showed a large number of highly fluorescent cells and zones of density and disorganized elastin fibers at alveolar areas. A combination of diagnostic endoscopic procedures is required to establish the diagnosis of NTM.
Assuntos
Broncoscopia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Infecções por HIV , Microscopia Confocal , Infecções por Mycobacterium não Tuberculosas , Humanos , Broncoscopia/métodos , Criança , Microscopia Confocal/métodos , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/patologia , Masculino , Infecções por HIV/complicações , Infecções por HIV/patologia , Biópsia/métodosRESUMO
Sjögren's syndrome is systemic autoimmune disease characterized by lymphocytic infiltration of various organs with wide frequency of pulmonary involvement. Diffuse cystic lung disease in Sjögren's syndrome is a rare condition and requires differential diagnosis with other cystic pathologies such as lymphangioleyomiomatosis or Langerhans cell histiocytosis. Probe-based confocal laser endomicroscopy (pCLE) is a method of in vivo investigation of airways and lung tissue on microscopic level during bronchoscopy. We used this method in diffuse cystic lung disease caused by Sjögren's syndrome. The pCLE image showed a large number of fluorescent cells presumably lymphocytes in bronchioles, dilated alveolar spaces with fluid and thin alveolar walls. We think that the presence of the bronchiolar cells pattern can be used to differentiate between the pulmonary manifestations of Sjögren's disease and other cystic lung diseases.
RESUMO
Probe-based confocal laser endomicroscopy (pCLE) is a method that produces microscopic imaging of a lung tissue during bronchoscopy. We report a case ot a patient with negative nasopharyngeal swabs and suspected lung cancer who underwent pCLE. The diagnosis of COVID-19 was confirmed by PCR analyses of lavage fluid and transbrohial biopsy. The pCLE image shows density of alveolar thickened fibres, disorganization of elastin network, and multiple large drops of intraalveolar secretions. As far as we know, this is the first pCLE image discribed in patient with COVID-19 at that moment.
Assuntos
COVID-19/diagnóstico , Microscopia Confocal/métodos , SARS-CoV-2/isolamento & purificação , Biópsia/métodos , Broncoscopia/métodos , HumanosRESUMO
Desquamative interstitial pneumonia is a rare disease that is predominantly associated with smoking. Surgical biopsy is usually recommended for the diagnosis of this disorder. Probe-based confocal laser endomicroscopy (pCLE) is a new method of minimally invasive in vivo microscopic image of airways and alveoli. We use this method for desquamative interstitial pneumonia in nonsmoker. The pCLE image shows thickened intra-alveolar septae and clusters of autofluorescent cells within the alveoli, which is unusual for non-smoking patients. We think this pattern can be used for differential diagnosis of desquamative interstitial pneumonia in nonsmokers.
Assuntos
Microscopia Intravital , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Broncoscopia , Feminino , Humanos , Microscopia Intravital/métodos , Microscopia Confocal , Pessoa de Meia-Idade , não FumantesRESUMO
We report a case of metastatic pulmonary calcification in a patient with chronic renal failure on hemodialysis and secondary hyperparathyroidism. The diagnosis was made by using a probe-based confocal endomicroscopy which showed specific structures in the lung tissue and was proven by a transbronchial lung biopsy. To the best of our knowledge, this is the first reported case of the confocal endomicroscopy findings in a patient with metastatic pulmonary calcification.