However, such cases have not been previously reported in Japan, so the present
patients represent two rare cases. All 3 patients reported outside of Japan were young, had severe symptoms, and were being treated with infliximab (anti-TNF-α antibody drug). Regarding the present two cases in Japan, patient 1 (43-year-old man) was diagnosed with CD at age 11 years, and because of active gastrointestinal symptoms, infliximab (anti-TNF-α antibody drug) was started. Patient 2 (76-year-old woman) was diagnosed with CD at age 44 years, and she had a relatively satisfactory clinical course on nutritional therapy alone. If we consider the present 2 patients and the 3 patients reported from outside of Japan, 4 of these Protein Tyrosine Kinase inhibitor 5 patients developed CD at a young age and had highly active gastrointestinal symptoms [9]. Therefore, when lung lesions are seen in patients who developed CD during their youth and have highly active gastrointestinal symptoms, CD-related granulomatous lung lesions must be considered. None. I thank special support for Department of Gastroenterology, Fukuoka University Chikushi Hospital. “
“Transbronchial biopsy (TBB) with the aid of radial endobronchial ultrasound (R-EBUS) had long been demonstrated to have a good diagnostic performance for peripheral pulmonary lesions (PPL) [1]. Almost
10 years ago, Kurimoto et al. introduced endobronchial ultrasound with a guide sheath (EBUS-GS) to augment TBB [2] Etofibrate and indeed, the overall diagnostic yield for PPLs increased to 70 percent [3]. A lung adenocarcinoma that presents as ground glass ABT-263 price opacity (GGO) on computed tomography (CT) screening is often detected these days [4], but majority of the patients either undergo surgical resection or are observed without definitive diagnosis. However, diagnostic bronchoscopy for GGO lesions, especially the pure type without a solid component, is not commonly performed because most respiratory physicians recognize that GGO cannot be visualized
on fluoroscopy or is undetectable by EBUS. In fact, several studies on bronchoscopic diagnosis of solid pulmonary nodules have already been published but only a few studies on GGO were reported [5]. Performing EBUS-GS for TBB of GGO is a challenging matter. To the best of our knowledge, an EBUS finding that represents a ground glass process is still unknown. In this case report, we describe the specific EBUS findings for GGO and highlight the importance of obtaining large pieces for definitive diagnosis. The representative case is that of an 81-year old female, non-smoker, with a 35 mm pure ground glass opacity (GGO) in the right lower lobe that was incidentally seen on computed tomography (CT) scan of the chest (Fig. 1A) but was indistinct on chest radiograph (Fig. 1B).