Deepankar Sharma

Diagnostic Utility of Transbronchial Cryobiopsy in Interstitial Lung Disease

Interstitial lung disease is a heterogenous group of disorders characterized by varying patterns of inflammation and fibrosis. Its diagnosis requires a multidisciplinary approach including clinical and imaging correlation, but atypical presentations and imaging warrant tissue biopsy. Transbronchial forceps biopsy has a low yield and is not recommended for diagnosis. Although considered as the gold standard, surgical lung biopsy is associated with significant morbidity and mortality. Transbronchial cryobiopsy is a relatively newer technique, but only limited data are available to establish its utility in diagnosing interstitial lung disease and evaluating the associated risks to this procedure.

The Role of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in the Diagnosis and the Subtyping of Lymphoma in the Mediastinum

Endobronchial ultrasound-guided transbronchial needle aspiration is a commonly performed procedure in patients with mediastinal lymphadenopathy. Its role has been widely established in the diagnosis and the staging of lung cancer and other benign disease, but there is still debatable evidence regarding its role in the diagnosis, the subtyping, and the treatment of lymphoproliferative diseases. Consequently, there are no guidelines or statements to guide the choice of diagnostic modality in such cases. We review the available literature to evaluate the myth that endobronchial ultrasound-guided transbronchial needle aspiration does not provide sufficient diagnostic material for the accurate diagnosis and subtyping of mediastinal lymphoma.

Myths and Legends: Vitamin K Antagonists Have a Better Safety Profile Than Direct Oral Anticoagulants in Patients Undergoing Bronchoscopic Procedures

Diagnostic bronchoscopy for obtaining tissue samples is a commonly performed procedure and is an extremely useful diagnostic tool for malignant and benign conditions. A significant proportion of patients who undergo these procedures are anticoagulated for conditions including atrial fibrillation, pulmonary embolism, and deep-vein thrombosis. With new classes of oral anticoagulants being prescribed more frequently, it is important that bronchoscopists are comfortable in the management of direct oral anticoagulants in the perioperative period.

Myths and Legends: Do We Need to Suck It Up?

Transbronchial needle sampling during bronchoscopy is a commonly performed procedure that can assist during diagnosis and staging of lung cancer. Typically, suction is applied during transbronchial needle aspiration but a number of studies have examined the role of transbronchial needle capillary sampling in which no suction is applied. We review the available literature to evaluate the myth that suction is always necessary and that it yields a better sample.

Myths and Legends: Does Needle Size Affect the Diagnostic Yield and Accuracy of Ebus-tbna?

Endobronchial ultrasound-transbronchial needle aspiration sampling during bronchoscopy is a commonly performed procedure that can assist during diagnosis and staging of lung cancer. Different needle size options exist and little has been published comparing the yields of the various options. We review the available literature to evaluate the myth that bigger is better.