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Nodule pulmonaire suspect chez un grand tabagique : faut-il faire une biopsie ?

Auteurs : Charif F1, Peretti L1, Kacimi D1, Bindler M1, Bugnet AS1
Affiliations : 1Service de pneumologie, hôpitaux du Léman, 3, avenue de la Dame, Thonon-lès-Bains, France.
Date 2024 Janvier 01, Vol 41, Num 1, pp 89-92Revue : Revue des maladies respiratoiresType de publication : présentations de cas; résumé en anglais; article de périodique; DOI : 10.1016/j.rmr.2023.11.002
Résumé

Sclerotherapy is a widely used as a lifesaving therapeutic option in cases of upper gastrointestinal bleeding (UGB) due to ruptured gastro-esophageal varices (GOV) in cirrhotic patients, especially when there exists a portosystemic shunt. This endoscopic technique can entail many complications, including systemic and non-thrombotic pulmonary embolism (PE). While multiple pulmonary parenchymal manifestations have been described following sclerotherapy of GOV, to our knowledge no solitary suspicious pulmonary nodule has been described.We report the case of 55-year-old man with heavy smoking history who was referred to our pulmonary clinic for work-up of a solitary pulmonary nodule. He was known to have liver cirrhosis with history of massive UGB due to rupture of GOV two months before. He was treated with sclerotherapy by injecting a 3 cc of Histoacryl/lipiodole solution. The post- endoscopic phase was unremarkable. An enhanced CT scan of chest and abdomen performed two months later showed a right upper lobe nodule, even though at that point, the patient was completely asymptomatic. This was ascribed to non-thrombotic PE secondary to sclerotherapy due to complete resolution of the nodule on a CT scan carried out at 2-month follow-up. At that point, his condition did not require any further treatment.Solitary pulmonary nodule is one of the radiologic manifestations of PE subsequent to sclerotherapy of GOV. Awareness and radiologic follow-up of this unusual radiologic presentation may prevent unnecessary biopsies.

Mot-clés auteurs
gastro-esophageal varices; nodule pulmonaire suspect; sclerotherapy; sclérothérapie; suspected pulmonary nodule; varices gastro-œsophagiennes;
 Source : MEDLINE©/Pubmed© U.S National Library of Medicine
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Charif F, Peretti L, Kacimi D, Bindler M, Bugnet A S. Nodule pulmonaire suspect chez un grand tabagique : faut-il faire une biopsie ?. Rev Mal Respir. 2024 Jan 01;41(1):89-92.
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Dernière date de mise à jour : 27/01/2024.


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