PMC7118411_01
Imaging and thoracoscopic findings of the patient in case 1.. (A) Chest X-ray shows dullness of the right costophrenic angle. (B) Computed tomography shows right pleural effusion with right lower lobe compressive atelectasis. (C) Thoracoscopic image shows diffuse dissemination of micronodules on the parietal pleura. (D) Thoracoscopic image shows use of the 1.9-mm cryoprobe, attached perpendicularly to the pleura and frozen for 6 seconds.
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Chest radiography showed dullness of the right costophrenic angle, while computed tomography scan of the chest revealed right pleural effusion with right lower lobe compressive atelectasis (Fig. 1A and B). Thoracoscopic findings showed diffuse dissemination of micronodules on the parietal pleura and fibrin adhesions between the visceral and parietal pleura (Fig. 1C). Pleural cryobiopsy was performed by using a 1.9-mm cryoprobe (ERBECRYO, ERBE, US) and the target area of the parietal pleura was frozen for 6 seconds (Fig. 1D).
Pathological findings of specimens from semi-flexible thoracoscopic cryobiopsy.. (A, B) Photomicrographs of the thoracoscopic cryobiopsy specimen from the patient in case 1, which show 200-300-mum caseating and non-caseating epitheloid cell granulomas with Langerhans type giant cells. (C, D) Photomicrographs of the thoracoscopic cryobiopsy specimen from the patient in case 2, which demonstrate epitheloid granuloma with necrosis and many Langerhans type giant cells, highly suggestive of tuberculosis.
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Specimens obtained from the cryoprobe are shown in Fig. 2C and D: these exhibited the size of 0.8 cm; microscopic findings demonstrated epitheloid granulomas with necrosis and many Langerhans type giant cells, highly suggestive of tuberculosis.
PMC7118411_02
Pathological findings of specimens from semi-flexible thoracoscopic cryobiopsy.. (A, B) Photomicrographs of the thoracoscopic cryobiopsy specimen from the patient in case 1, which show 200-300-mum caseating and non-caseating epitheloid cell granulomas with Langerhans type giant cells. (C, D) Photomicrographs of the thoracoscopic cryobiopsy specimen from the patient in case 2, which demonstrate epitheloid granuloma with necrosis and many Langerhans type giant cells, highly suggestive of tuberculosis.
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Specimens obtained from the cryoprobe are shown in Fig. 2C and D: these exhibited the size of 0.8 cm; microscopic findings demonstrated epitheloid granulomas with necrosis and many Langerhans type giant cells, highly suggestive of tuberculosis.
Imaging and thoracoscopic findings of the patient in case 2.. (A-B) Chest X-ray and computed tomography scan show massive right pleural effusion. (C) Thoracoscopic image shows diffuse dissemination of micronodules on the parietal pleura. (D) Thoracoscopic image shows use of the 1.9-mm cryoprobe, attached perpendicularly to the pleura and frozen for 6 seconds.
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Chest radiography and computed tomography scan of the chest revealed massive right pleural effusion (Fig. 3A and B). For definitive diagnosis, pleural biopsy was performed via thoracoscopic cryobiopsy (Fig. 3C and D), using a freezing time of 6 seconds.