A toddler with a cough and wheeze refractory to treatment

Cryotherapy has multiple uses in adult pulmonology including removal of foreign bodies and transbronchial biopsy to diagnose granulomatous disease, infection, interstitial lung disease, lung cancer and post-transplant rejection. After a multidisciplinary discussion including an adult respiratory phy...

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Bibliographic Details
Published inThorax Vol. 72; no. 10; pp. 953 - 955
Main Authors Shanthikumar, Shivanthan, Lwin, Tommy, Chow, Chung W, Crameri, Joe, Harrison, Jo
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.10.2017
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Summary:Cryotherapy has multiple uses in adult pulmonology including removal of foreign bodies and transbronchial biopsy to diagnose granulomatous disease, infection, interstitial lung disease, lung cancer and post-transplant rejection. After a multidisciplinary discussion including an adult respiratory physician specialising in EBUS, a paediatric general surgeon and an anatomical pathologist, it was decided that although EBUS TBNA would be feasible, a needle aspirate might not provide a sample sufficient for diagnosis if the mass was due to a lymphoma such as Hodgkin's lymphoma which has a non-uniform population of tumour cells, and hence may be missed on an aspirate. [...]the patient was referred for a thoracoscopic biopsy. [...]in TST-positive cases, without risk factors for TB, who are clinically stable, withholding TB treatment while awaiting microbiological confirmation of the causative organism can be considered.
Bibliography:ObjectType-Case Study-2
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ISSN:0040-6376
1468-3296
DOI:10.1136/thoraxjnl-2016-209915