Mehta AC, Wang J, Abuqayyas S, Garcha P, Lane CR, Tsuang W, Budev M, Akindipe O. New Nodule-Newer Etiology. World J Transplant 2016; 6(1): 215-219 [PMID: 27011920 DOI: 10.5500/wjt.v6.i1.215]
Corresponding Author of This Article
Atul C Mehta, MBBS, FACP, FCCP, Professor of Medicine, Lerner College of Medicine, Staff, Respiratory Institute Cleveland Clinic, 9500 Euclid Avenue, A-90, Cleveland, OH 44195, United States. mehtaa1@ccf.org
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Study
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Mehta AC, Wang J, Abuqayyas S, Garcha P, Lane CR, Tsuang W, Budev M, Akindipe O. New Nodule-Newer Etiology. World J Transplant 2016; 6(1): 215-219 [PMID: 27011920 DOI: 10.5500/wjt.v6.i1.215]
World J Transplant. Mar 24, 2016; 6(1): 215-219 Published online Mar 24, 2016. doi: 10.5500/wjt.v6.i1.215
New Nodule-Newer Etiology
Atul C Mehta, Juan Wang, Sami Abuqayyas, Puneet Garcha, Charles Randy Lane, Wayne Tsuang, Marie Budev, Olufemi Akindipe
Atul C Mehta, Juan Wang, Sami Abuqayyas, Puneet Garcha, Charles Randy Lane, Wayne Tsuang, Marie Budev, Olufemi Akindipe, Respiratory Institute Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Mehta AC participated in the design of the study, data collection, statistical analysis, interpretation of the results, writing and critical revision of the manuscript for important intellectual content and final approval of the manuscript submitted; Mehta AC was the guarantor of the paper, taking responsibility for the integrity of the work as a whole, from inception to published article; Wang J and Abuqayyas S participated in the data collection, interpretation of the results and critical revision of the manuscript for important intellectual content and final approval of the manuscript submitted; Abuqayyas S performed the statistical analysis; Garcha P, Lane CR, Tsuang W and Budev M participated in the interpretation of the results, writing and critical revision of the manuscript for important intellectual content and final approval of the manuscript submitted; Akindipe O participated in the conception of the study, interpretation of the results and critical revision of the manuscript for important intellectual content and final approval of the manuscript submitted.
Institutional review board statement: The study was approved by the Institutional Review Board of the Cleveland Clinic, Cleveland, Ohio.
Informed consent statement: Due to the retrospective nature of the study there was no need to obtain patient consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Correspondence to: Atul C Mehta, MBBS, FACP, FCCP, Professor of Medicine, Lerner College of Medicine, Staff, Respiratory Institute Cleveland Clinic, 9500 Euclid Avenue, A-90, Cleveland, OH 44195, United States. mehtaa1@ccf.org
Telephone: +1-216-4442911 Fax: +1-216-4458160
Received: April 9, 2015 Peer-review started: April 10, 2015 First decision: September 2, 2015 Revised: October 31, 2015 Accepted: November 24, 2015 Article in press: November 25, 2015 Published online: March 24, 2016 Processing time: 343 Days and 23.8 Hours
Abstract
AIM: To evaluate frequency and temporal relationship between pulmonary nodules (PNs) and transbronchial biopsy (TBBx) among lung transplant recipients (LTR).
METHODS: We retrospectively reviewed 100 records of LTR who underwent flexible bronchoscopy (FB) with TBBx, looking for the appearance of peripheral pulmonary nodule (PPN). If these patients had chest radiographs within 50 d of FB, they were included in the study. Data was compared with 30 procedures performed among non-transplant patients. Information on patient’s demographics, antirejection medications, anticoagulation, indication and type of lung transplantation, timing of the FB and the appearance and disappearance of the nodules and its characteristics were gathered.
RESULTS: Nineteen new PN were found in 13 procedures performed on LTR and none among non-transplant patients. Nodules were detected between 4-47 d from the procedure and disappeared within 84 d after appearance without intervention.
CONCLUSION: FB in LTR is associated with development of new, transient PPN at the site of TBBx in 13% of procedures. We hypothesize that these nodules are related to local hematoma and impaired lymphatic drainage. Close observation is a reasonable management approach.
Core tip: Transbronchial biopsy (TBBx) is routinely performed in lung transplant recipients (LTR). The development of pulmonary nodules (PNs) in this population is common. We investigated LTR who developed PNs post TBBx to determine the temporal relationship between the procedure and the timing of appearance and disappearance of these nodules. Our conclusion is that TBBx in LTR is associated with development of transient nodules at the site of TBBx in 13% of procedures. We hypothesize that these nodules are related to local hematoma and impaired lymphatic drainage. Close observation is a reasonable management approach.
