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The Cryo-Needle: A New Tool for Histological Biopsies. A Feasibility Study

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Abstract

Purpose

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure for intrathoracic lymph node biopsies. The newly developed cryo-needle operates in a similar way to the EBUS-TBNA but is able to obtain specimens for histological evaluation. The purpose of this animal study was to evaluate the feasibility, effect, and safety of the cryo-needle biopsies.

Methods

Four EBUS-guided cryo-needle biopsies were obtained from a mediastinal lymph node of a healthy pig. In an open surgery approach, cryo-needle biopsies using activation times of 1, 2, and 3 s (A1/A2/A3) and needle biopsies using a 21-gauge EBUS-TBNA needle were obtained from mesenteric lymph nodes. Cryo-needle biopsies A2 were performed with (A2+) and without (A2−) an oversheath. The size, weight, percentage of lymphatic tissue and artefact-free area of each cryobiopsy were evaluated. Smears were made with the TBNA-needle aspirates to determine the number of lymphocytes per high-power field (HPF). The bleeding duration was measured.

Results

We successfully obtained EBUS-guided cryo-needle biopsies. The area and weight of the biopsies A3 and A2+ were significantly larger compared with A1 (1.7 ± 0.8 and 1.4 ± 0.3 vs. 0.9 ± 0.4 mm2; 5.2 ± 2.4 and 3.4 ± 1.8 vs. 1.5 ± 0.7 mg). The percentage of lymphatic tissue of the cryobiopsies was 90 ± 25 and 98 % of samples were artefact-free. The number of lymphocytes/HPF of TBNA-needle smears was 128 ± 54.3. There was no difference in bleeding duration between the techniques.

Conclusions

The cryo-needle yields large histological specimens of high quality.

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Conflict of interest

Karl-Josef Franke, Georg Nilius, Karl-Heinz Ruehle, and Claus Hann von Weyhern declare that they have no conflict of interest. Markus D. Enderle is Medical Director of the Research Department, ERBE Germany and Walter Linzenbold is a researcher at ERBE Germany.

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Authors and Affiliations

  1. Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Chair of Internal Medicine I, Witten/Herdecke University, Ambrocker Weg 60, 58091, Hagen, Germany

    Karl-Josef Franke, Georg Nilius & Karl-Heinz Ruehle

  2. ERBE Research, Waldhoernlestrasse 17, 72070, Tuebingen, Germany

    Markus D. Enderle & Walter Linzenbold

  3. Department of Pathology, Municipal Hospital Complex Munich, Harlaching, Sanatoriumsplatz 2, 81545, Munich, Germany

    Claus Hann von Weyhern

Authors
  1. Karl-Josef Franke
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  2. Georg Nilius
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  3. Karl-Heinz Ruehle
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  4. Markus D. Enderle
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  5. Walter Linzenbold
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  6. Claus Hann von Weyhern
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Correspondence to Karl-Josef Franke.

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Franke, KJ., Nilius, G., Ruehle, KH. et al. The Cryo-Needle: A New Tool for Histological Biopsies. A Feasibility Study. Lung 191, 611–617 (2013). https://doi.org/10.1007/s00408-013-9502-4

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  • DOI: https://doi.org/10.1007/s00408-013-9502-4

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