Medical Image of the Week: EBUS

  

 Image 1.      

 Image 2.

This patient with a history of smoking was referred from an outside pulmonary clinic for a CT chest showing two enlarged right paratracheal nodes.  The larger structure (Image 1) was found to have a hypoechoic appearance under endobronchial ultrasound, which is atypical of a lymph node.  Upon needle aspiration, the structure collapsed and serous fluid was collected.  The smaller lymph node (Image 2) showed the normal hyperechoic presentation and yielded normal lymphatic tissue when sampled.

Wendy Hsu, MD and James Knepler, MD

Division of Pulmonary and Critical Care Medicine

Arizona Respiratory Center

University of Arizona 

Reference as: Hsu W, Knepler J. Medical image of the week: EBUS. Southwest J Pulm Crit Care 2012;5:300. PDF

Medical Image of the Week: Bronchial Clot

This patient was admitted from oncology clinic for ten days of hemoptysis on Coumadin.  Her laboratory data on admission showed a platelet count of 14,000/μL and an INR of 4.5.  She was found on bronchoscopy with her right mainstem completely occluded by a clot.  A cryoprobe was used and the clot was removed in one piece as seen above in a 4 x 4 container.  The clot was notable to have the cast of the right mainstem bronchial rings as well as impressions of the right upper, right middle, and right lower lobe bronchus.  The entire length of the clot was approximately four centimeters. 

Wendy Hsu, MD and Yuval Raz, MD

Division of Pulmonary and Critical Care Medicine

Arizona Respiratory Center

University of Arizona

Reference as: Hsu W, Raz Y. Medical image of the week: bronchial clot. Southwest J Pulm Crit Care 2012;5:296. PDF