14/06/2025
🩺 Another case highlighting the value of radial EBUS
👩⚕️ A woman in her 40s presented to another center with several weeks of cough and occasional hemoptysis.
🖼️ CT thorax showed a right upper lobe (RUL) mass.
🫁 Initial bronchoscopy was non-diagnostic, and a CT-guided biopsy reported as ?ILD.
🔄 Referred to our center for second opinion.
🧭 After discussion, options were:
Repeat CT-guided biopsy
Or
Proceed with radial EBUS via endobronchial approach
✅ We opted for radial EBUS-guided forcep biopsy under fluoroscopy and conscious sedation.
⚠️ It wasn’t straightforward — the patient developed a persistent cough after the first biopsy, making sampling difficult.
🔎 Still, we managed to identify and biopsy a concentric RB3bi lesion.
🧬 Histopathology: Hodgkin lymphoma
📆 She is now scheduled for a whole-body PET-CT.
If no other abnormal uptake is found, this may be a rare case of Primary Pulmonary Hodgkin Lymphoma (PPHL).
📚 Learning point: When initial bronchoscopy or CT-guided biopsies are inconclusive, radial EBUS with fluoroscopy offers a targeted, minimally invasive solution — especially for rare diagnoses like pulmonary lymphoma.