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Thursday, April 24, 2014
Can CT show need for bronchoscopy?
Hilar & mediastinal lymph node enlargement 2 mos ago. Now hemoptysis usually in morning-small amounts. Further ct to be done next week. What radiological testing prior to broncho might show the actual need for bronchoscopy? Barium swallow? Or,if Ct of chest doesn`t reveal the source of bleeding,would bronchoscopy still be worthwhile? Would it then be done to look for hidden accessible lymph nodes to biopsy, re: granuloma characteristics?
CT scans and bronchoscopy are usually complementary studies. Fiberoptic bronchoscopy with biopsy is utilized as a means of diagnosing abnormalities in the lung, lymph nodes or airways. CT scans assist in guiding biopsy location but may not always detect sources of hemoptysis. In particular, suspected abnormalities in the airways often require bronchoscopy for localization. Bronchoscopy should be performed in unexplained cases of hemoptysis. There are several methods for lymph node biopsy including transbronchial needle biopsy, CT guided biopsy and surgical biopsy. You should discuss with your health care provider the best approach to biopsy.
Patrick Nana-Sinkam, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University