Joshi S, Gupta R, Bhatia A, Ali SJ. The Sonoelastographic Characters of Noncomplicated Bronchogenic Cyst: An Evaluation Using CP-EBUS. J Assoc Chest Physicians 2018;6:41-3.

Endobronchial ultrasound (EBUS) is a relatively newer technique useful in the mapping and guiding of the needle aspirates/biopsy of the mediastinal nodes and lesions. Sonoelastography attached to the latest-generation EBUS machines has enabled the mapping of the elasticity of the lymph nodes leading to better guidance while taking samples. We present the sonographic images and characteristics of a bronchogenic cyst visualized on EBUS elastography.

Keywords: Bronchogenic cyst, elastography, ultrasound

How to cite this article:
Joshi S, Gupta R, Bhatia A, Ali SJ. The Sonoelastographic Characters of Noncomplicated Bronchogenic Cyst: An Evaluation Using CP-EBUS. J Assoc Chest Physicians 2018;6:41-3

How to cite this URL:
Joshi S, Gupta R, Bhatia A, Ali SJ. The Sonoelastographic Characters of Noncomplicated Bronchogenic Cyst: An Evaluation Using CP-EBUS. J Assoc Chest Physicians [serial online] 2018 [cited 2021 Nov 24];6:41-3. Available from: https://www.jacpjournal.org/text.asp?2018/6/1/41/220986

Introduction
Top

Endobronchial ultrasound (EBUS)-based elastography is a noninvasive technology performed during EBUS, in which the relative stiffness of the tissues can be assessed as a color map, which can be used to differentiate the malignant from benign lesions.[1] This could guide the fine-needle aspirate site and could improve the diagnostic yields. There has been a paucity of reports describing EBUS elastography images and color combinations for nonmalignant lesions. Herein, we report the EBUS elastography image of a mediastinal bronchogenic cyst, which looked homogenous, with a single color enhancement on the elastography mode.

Case

An 18-year-old female was referred to the pulmonology clinic for complaints of dry cough. The patient was referred for a pre-anesthetic checkup for a planned thyroid nodule surgery. Computerised tomography (CT) thorax showed a smooth-walled mediastinal mass in right paratracheal position. Fiberoptic bronchoscopy with EBUS transbronchial needle aspiration (TBNA) was planned to evaluate the lesion before thyroid surgery. After local anesthesia to the pharynx with 4% lidocaine spray, each patient was placed under conscious sedation with intravenous propofol. The convex probe EBUS (CP-EBUS; BF-UC260FW, Olympus, Tokyo, Japan) was inserted through the oral route, with an intermittent instillation of 2-ml aliquot doses, which had 2% lidocaine. Scanning was done on a 7.5-MHz frequency US, and images were generated using a new, dedicated US processor (EU-ME2 PREMIER PLUS, Olympus, Tokyo, Japan).

On the CP-EBUS, there was a distinct smooth homogenous round lesion towards the right intermediate bronchus wall [Figure 1]. Sonoelastography showed homogenous green color with a few streaks of yellow [Figure 2]. Based on the findings, it was inferred to be a cystic lesion. No attempt was made to aspirate the cyst, because it would have led to complications associated with the leakage of cystic contents. Thoracic surgery opinion was taken. An open thoracotomy and subsequent excision of the cyst confirmed the presence of a bronchogenic cyst.