Usefulness of Cell Blocks From Forceps and Brush Washing Fluid in Bronchoscopy / 日本農村医学会雑誌

Background: Cell blocks (CBs) from pleural fluid are frequently used in the practice of respiratory medicine, but there have been few reports on the use of CBs from forceps and brush washing fluid in bronchoscopy for pathological diagnosis. We retrospectively analyzed the usefulness of CBs from forceps and brush washing fluid. 　Patients and Methods: Patients who underwent bronchoscopy and had CBs made from forceps and brush washing fluid in bronchoscopy at our institution between June 2016 and May 2021 were included. Cases in which additional information was obtained from CBs were reviewed in detail. 　Results: In total, 138 patients had CBs made from forceps and brush washing fluid in bronchoscopy during the study period. EBUS-GS (endobronchial ultrasound-guide sheath) was used for 102 of these patients. The final diagnosis was lung cancer in 114 cases, infection disease in 10 cases, metastatic lung tumor in 8 cases, lymphoproliferative disease in 2 cases, sarcoidosis in 1 case, and organizing pneumonia in 1 case. There were 13 cases with additional information obtained from CBs, all of which were cases of malignant tumors. 　Conclusions: CBs from forceps and brush washing fluid in bronchoscopy were useful for pathological diagnosis in some cases.

Sepsis due to the Iliopsoas Muscle Abscess in Old Man / 日本農村医学会雑誌

　　The patient was an 84-year-old man. On July 1, 20XX, he experienced great difficulty in walking. On July 3, he suffered from serious complaints of backache and hyperhidrosis and was rushed off to a nearby hospital. A blood test was performed immediately. It showed that all the values conformed to DIC criteria. (?) A ultrasound scan revealed phiebothrombosis in the deep part of the legs. CT using a contrast medium found iliopsoas muscle abscess and periaortitis. The man was diagnosed with DIC, multiple organ failue, septic shock, and deep part phiebothrombosis. Treatment was done with an antimicrobial medicine and immunoglobulin preparations. In addition, an anticoagulant therapy was performed using DOA and heparin. Inflammation began to subside gradually but his fever did not abate. Contrast enhanced CT indicated abscess all over the body. After a 34-day stay in the hospital, he died. Although this case occurred in an urban area, MRSA was detected in the patient, suggesting that this strain is now one of the omnipresent bacteria. In this respect, this case was significant. Generally, a drainage procedure is taken for the treatment of iliopsoas muscle abscess. However, in this case, a remedial drainage was not used because the diameter of abscess was so small. As his temperature did not fall, a diagnostic drainage should have been used.