case_images: PMC11749508_01
case_images: Chest CT of the patient. (A, B) CT: the presence of a right pulmonary mass, right lower lobar bronchus obstruction, and right pleural effusion. (C) CT: a new lesion appeared in the right intermediate bronchus. (D) CT: The lesion reobstruction in the right intermediate bronchus. (E) CT: 125I seeds were implanted in the lesion of the right middle lobe and 12R. (F) CT: lesion reduction and right middle lobe recruitment. CT = computed tomography.
case_images: medi-104-e41198-g001.jpg
case_images: PMC11749508_01_medi-104-e41198-g001.jpg
case_images: F1
case_images: A previously healthy 64-year-old female patient with a recurring cough and a large mass in right lower lung that showed right lower lung bronchial obstruction (Fig. 1A, B). Chest CT revealed a new lesion in the right intermediate bronchus (Fig. 1C). Nevertheless, less than 1-month postdischarge, the patient experienced recurring MCAO (Fig. 1D). Following these treatments, MCAO had never recurred and the lesion continued to shrink (Fig. 1E, F).
case_images: Bronchoscope and radioactive 125I seed implantation. (A, B) Bronchoscopy conducted on June 21, 2022: a new lesion in the right intermediate bronchus that had spread to the right middle lobe bronchus and the lesion was removed using snare. (C, D) Bronchoscopy on July 25, 2022: the right intermediate bronchus was entirely obstructed. Despite repeated use of snare to remove new lesion from the right middle bronchus, the distal segment remained invisible. (E, F) Implantation of radioactive 125I seeds in the right middle lobe lesion and 12R lymph node via bronchoscopy and EBUS guidance.
case_images: medi-104-e41198-g002.jpg
case_images: PMC11749508_01_medi-104-e41198-g002.jpg
case_images: F2
case_images: Guided by bronchoscopy, we then used an electric snare to remove the new lesion (Fig. 2A, B). Despite repeated use of the snare to remove new lesion from the right middle bronchus, the distal segment remained invisible (Fig. 2C, D). Three 125I seeds with an activity of 0.65 mci were released in the lesion in the right middle lobe bronchus by the guide of conventional bronchoscopy, and meanwhile 4 125I seeds with an activity of 0.65 mci were implanted at a 0.5 cm interval in the right group 12 (12R) enlarged lymph nodes located at the anterior to the opening of the right middle and lower lobe guided by EBUS (Fig. 2E, F).