AME Case Reports最新文献

{"title":"Inferior vena cava filter retrieval with radial jaw biopsy forceps: a case report.","authors":"Baylor Akhavan, Brian Kerlin, Rachel Soong, Alexander Kieger, Brandon Chen","doi":"10.21037/acr-2026-0094","DOIUrl":"https://doi.org/10.21037/acr-2026-0094","url":null,"abstract":"<p><strong>Background: </strong>Inferior vena cava (IVC) filters are used in patients at risk for venous thromboembolism (VTE) who cannot receive anticoagulation. Prolonged dwell times are associated with increased risk of embedment, endothelialization, and retrieval failure, often necessitating advanced techniques. While endobronchial forceps are commonly used in complex retrievals, the role of alternative biopsy devices remains limited. We present the following case highlighting the use of radial jaw biopsy forceps for IVC filter retrieval, a technique with minimal prior documentation.</p><p><strong>Case description: </strong>A man in his late 30s with a history of recurrent deep vein thromboses presented with progressive bilateral lower extremity swelling and an indwelling IVC filter with an estimated dwell time of approximately 5 years. Imaging demonstrated severe iliocaval obstruction and collateral formation. Initial retrieval attempts using standard snare, loop snare, and hangman techniques were unsuccessful due to fibrotic encapsulation and deformation of the filter. In the absence of rigid endobronchial forceps, radial jaw biopsy forceps were utilized to dissect fibrous tissue and successfully engage and remove the filter. Residual struts were excluded with bilateral iliac vein stenting, resulting in improved venous outflow.</p><p><strong>Conclusions: </strong>Radial jaw biopsy forceps may serve as a viable alternative in complex IVC filter retrieval when conventional and advanced techniques fail or are unavailable. This case expands the spectrum of available tools and highlights the importance of procedural adaptability in interventional radiology (IR).</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"166"},"PeriodicalIF":0.6,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-assisted multidisciplinary therapy for a complex case of cholangitis with septic shock: a case report and simulated decision-making analysis.","authors":"Youfang Wang, Yongfei He, Shutian Mo, Chunyi Zhu, Jingren Shao, Chuangye Han, Tao Peng","doi":"10.21037/acr-2026-0055","DOIUrl":"10.21037/acr-2026-0055","url":null,"abstract":"<p><strong>Background: </strong>Acute cholangitis secondary to choledocholithiasis can rapidly progress to septic shock, with multidisciplinary team (MDT) management serving as the cornerstone of its. The potential of artificial intelligence (AI) in simulating such complex clinical decision-making remains underexplored. This study aims to examine the central role of MDT in the management of complex biliary septic shock and to evaluate the feasibility and value of AI in simulating clinical decision-making processes.</p><p><strong>Case description: </strong>A 52-year-old female patient was admitted with septic shock (blood pressure 91/45 mmHg, heart rate 156 bpm) secondary to choledocholithiasis. Concurrently with real-world MDT management, we employed two large language models (DeepSeek and ChatGPT-5) to simulate MDT decision-making using a standardized clinical prompt. Both AI models demonstrated high concordance with the human MDT on core principles (immediate decompression, broad-spectrum antibiotics) but diverged on specific strategies, favoring percutaneous transhepatic cholangial drainage (PTCD) over the human team's choice of endoscopic intervention. Following a real-world MDT discussion, emergency endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic nasobiliary drainage (ENBD) was performed. Due to rising amylase (peak 486 U/L) suggesting possible ENBD-related pancreatic duct obstruction, the ENBD was exchanged for an endoscopic retrograde biliary drainage stent on day 6. Concurrently, antibiotic therapy was escalated to imipenem-cilastatin. With this comprehensive strategy, the patient stabilized.</p><p><strong>Conclusions: </strong>MDT is pivotal in complex biliary septic shock. AI demonstrates potential to replicate core diagnostic and therapeutic logic, but current models lack deep perception of \"clinical reality feasibility\". AI is a promising decision support tool, particularly in resource-limited settings, but human contextual adaptation remains irreplaceable.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"147"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13467008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and operative challenge of a giant non-pancreatic intra-abdominal pseudocyst: a rare case report.","authors":"Om Jhaveri, Katie Scott, Joseph Galloway","doi":"10.21037/acr-2026-0095","DOIUrl":"10.21037/acr-2026-0095","url":null,"abstract":"<p><strong>Background: </strong>Large, non-pancreatic pseudocysts are rare pathologies that present as lesions in the intra-abdominal wall or peritoneal cavity. These cases can be diagnostically difficult, particularly in situations where fine-needle aspiration yields nonspecific cytology and imaging is also often nonspecific and nondiagnostic. These lesions may mimic hematomas, seromas, cystic neoplasms, and other bowel-related pathologies, which may require surgical excision for definitive diagnosis and curative treatment.</p><p><strong>Case description: </strong>We present a case of a 73-year-old male with a body mass index of 43 who presented to the emergency department for a ureteral stone and was found on computed tomography (CT) imaging incidentally to have a large left lower quadrant abdominal wall mass. The lesion was highly vascularized and intimately adherent to both the abdominal wall and colon. Two separate biopsy results showed nonspecific cytology and hemorrhagic debris. Operative excision required tedious removal from the bowel and abdominal wall and evacuation of 3 L of fluid. Pathology results showed a chronic pseudocyst lacking an epithelial lining.</p><p><strong>Conclusions: </strong>The case demonstrates the diagnostic limitations of fine-needle aspiration and imaging, along with the potential for abdominal pseudocysts to mimic multiple differentials. Additionally, it highlights the importance of complete surgical excision for diagnostic and curative treatment.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"140"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel endovascular retrieval of duodenal-penetrating inferior vena cava filters: a report of two cases and technical considerations.","authors":"Bin Zhang, Zhen Yang, Xiquan Zhang","doi":"10.21037/acr-2026-0053","DOIUrl":"10.21037/acr-2026-0053","url":null,"abstract":"<p><strong>Background: </strong>Inferior vena cava (IVC) filters are widely used to prevent pulmonary embolism in patients with venous thromboembolism. However, failure to remove retrievable filters within the recommended time window leads to significant long-term complications, the incidence of which has been gradually increasing. While filter tilt, adhesion, and venous wall penetration are commonly encountered, rare complications such as duodenal perforation by a filter foot or recovery hook present unique clinical challenges. Conventionally, such cases have necessitated open surgical removal due to the high risk of massive hemorrhage or bowel injury associated with standard endovascular retrieval techniques. Conventional endovascular retrieval is contraindicated for permanent filters or when the recovery hook has penetrated the IVC wall. This case series demonstrates the successful application of a novel endovascular technique in these two extreme scenarios.</p><p><strong>Case description: </strong>We describe two patients with IVC filters that had been implanted for 9 and 8 years, respectively, who presented with epigastric pain and were found on gastroscopy to have a filter foot penetrating the duodenal wall. In the first case, a permanent Simon Nitinol filter lacked a recovery hook; in the second, the recovery hook of a Günther Tulip filter had itself pierced the IVC wall, and the filter foot was located in close proximity to the abdominal aorta. Both patients were deemed poor candidates for conventional intervention or refused open surgery. A novel endovascular technique was employed utilizing a combination of balloon-assisted intimal peeling, customized LOOP technology applied to the filter body, and real-time intra-arterial roadmap guidance via a pigtail catheter in the aorta.</p><p><strong>Conclusions: </strong>This novel endovascular technique offers a minimally invasive alternative for complex cases involving permanent filters and IVC-penetrating recovery hooks, with potential applicability in experienced interventional centers, though further validation is required.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"142"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent human epidermal growth factor receptor 2-positive breast cancer with axillary nodal metastasis in a patient with pituitary prolactinoma: a case report.","authors":"Jia-Feng Duan, Tian Li, Qiu-Juan Zhang, Jia-Hui Lu","doi":"10.21037/acr-2026-0018","DOIUrl":"10.21037/acr-2026-0018","url":null,"abstract":"<p><strong>Background: </strong>Managing high-risk human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) concurrent with a functioning pituitary adenoma is clinically challenging. Current oncological guidelines lack specific clinical consensus protocols regarding the simultaneous administration of intensive dual-HER2 targeted therapy, tyrosine kinase inhibitors (TKIs), and continuous dopamine agonists.</p><p><strong>Case description: </strong>A 56-year-old postmenopausal woman with a 5-year history of pituitary prolactinoma presented with a painless left breast mass over a 2-year duration. Her serum prolactin (PRL) was strictly pharmacologically controlled within the normal physiological range (8-15 ng/mL). Diagnostic breast magnetic resonance imaging (MRI) revealed a suspicious 3 mm × 5 mm spiculated nodule [Breast Imaging Reporting and Data System (BI-RADS) 4a]. She initially underwent an excisional biopsy which confirmed invasive carcinoma. Due to intraoperative sentinel lymph node positivity, the tumor's proximity to the nipple, and the patient's explicit refusal of breast conservation, she underwent a left modified radical mastectomy. Definitive surgery demonstrated a pathologically paradoxical finding: a minute 0.8 cm (pT1b) invasive ductal carcinoma accompanied by early axillary lymph node metastasis (pN1a, 2/27 positive nodes). The tumor exhibited high proliferative potential (Ki-67 40%) and parallel HER2 amplification (3+) in both the invasive and the high-grade ductal carcinoma in situ (DCIS) components. Adhering to a multidisciplinary plan while maintaining her cabergoline regimen uninterrupted, she received adjuvant chemotherapy, dual anti-HER2 blockade (trastuzumab and pertuzumab), and radiotherapy. She declined extended adjuvant neratinib due to gastrointestinal toxicity concerns. She remains completely disease-free at 36 months post-surgery with stable pituitary function.</p><p><strong>Conclusions: </strong>This case underscores the ongoing safety, feasibility, and practical compatibility of integrating dopamine agonists with intensive BC therapies. Furthermore, the paradoxical early lymphatic dissemination of a sub-centimeter primary tumor under physiological PRL levels suggests profound local crosstalk between HER2 and PRL receptor (PRLR) signaling. This necessitates vigilant management of even small, highly proliferative lesions in patients with concurrent endocrine comorbidities.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"141"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic portal hypertension with transfusion-associated hemolytic anemia: a case report.","authors":"Zhen Yang, Bin Zhang","doi":"10.21037/acr-2026-0052","DOIUrl":"10.21037/acr-2026-0052","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic portal hypertension (IPH) is a rare non-cirrhotic cause of non-cirrhotic portal hypertension, characterized by splenomegaly, hypersplenism, and recurrent variceal bleeding. Transfusion-associated hemolytic anemia with autoimmune features following red blood cell transfusion is an uncommon but serious complication, and its occurrence in IPH patients undergoing invasive procedures has rarely been reported. This study aims to report a rare case of idiopathic portal hypertension complicated by transfusion-associated hemolytic anemia and to describe the clinical outcomes of covered stent transjugular intrahepatic portosystemic shunt followed by glucocorticoid therapy.</p><p><strong>Case description: </strong>A 20-year-old woman with a 3-year history of recurrent hematemesis and melena presented with acute upper gastrointestinal bleeding. She had chronic anemia (hemoglobin 56 g/L), severe splenomegaly crossing the anterior midline, and hypersplenism (white blood cell 1.53×10⁹/L, platelets 35×10⁹/L). Liver function and coagulation were preserved, and contrast-enhanced computed tomography (CT) showed portal hypertension without cirrhosis. Comprehensive workup excluded viral hepatitis, autoimmune liver disease, Budd-Chiari syndrome, and myeloproliferative neoplasms, leading to a diagnosis of IPH. She underwent covered stent transjugular intrahepatic portosystemic shunt (TIPS) placement, with portal pressure decreasing from 41 to 30 cmH₂O. On postoperative day one, after transfusion of washed red blood cells, she developed acute jaundice, dark urine, and worsening anemia (hemoglobin 46 g/L). Laboratory findings revealed indirect hyperbilirubinemia (indirect bilirubin 72.0 µmol/L) and positive direct/indirect anti-human globulin tests, confirming transfusion-associated hemolytic anemia with autoimmune features. She was treated with methylprednisolone (40 mg/day) followed by oral prednisone tapered over 3 months, along with urinary alkalinization and choleretic agents. Hemolysis resolved within 3 days, and no recurrent bleeding occurred despite recent variceal hemorrhage. At 12-month follow-up, the TIPS remained patent, gastroscopy confirmed absence of esophageal varices, and hypersplenism parameters normalized without need for splenectomy.</p><p><strong>Conclusions: </strong>Covered stent TIPS may effectively control portal hypertension and improve hypersplenism in select IPH patients. However, transfusion-associated hemolytic anemia is a potential complication in alloimmunized patients receiving transfusions during TIPS, requiring prompt diagnosis and glucocorticoid therapy. Multidisciplinary collaboration among hepatologists, hematologists, and interventional radiologists is essential for optimal outcomes.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"145"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe hyponatremia masking cryptococcal meningitis in a fingolimod-treated patient: a case report.","authors":"Shun Nakahara, Bradley Fujiuchi, Toru Nakata, Lorrance L Majewski","doi":"10.21037/acr-2026-0110","DOIUrl":"10.21037/acr-2026-0110","url":null,"abstract":"<p><strong>Background: </strong>Cryptococcal meningitis is a life-threatening fungal infection and diagnostic delays have been associated with increased mortality. In individuals without human immunodeficiency virus infection, immunosuppressive medications are important risk factors for this condition. As it typically affects immunocompromised patients, cryptococcal meningitis may present without classic meningeal signs. In addition, hyponatremia is associated with central nervous system infection and may contribute to encephalopathy, potentially making the diagnosis even more challenging.</p><p><strong>Case description: </strong>A 77-year-old man with a history of multiple sclerosis receiving fingolimod for 15 years presented with a four-week history of progressive confusion. On presentation, he was afebrile. Physical examination revealed a lethargic appearance with disorientation to place, without meningeal signs or new focal neurologic deficits. Laboratory evaluation demonstrated severe hyponatremia and lymphopenia. Head computed tomography (CT) was unremarkable. Cerebrospinal fluid (CSF) analysis showed mild pleocytosis and mildly elevated protein levels, with a normal opening pressure. CSF smear demonstrated encapsulated round yeast-like organisms. Cryptococcal polymerase chain reaction of the CSF was positive, and both CSF and blood cultures grew <i>Cryptococcus neoformans</i>, consistent with disseminated cryptococcosis. Dual antifungal therapy with liposomal amphotericin B and flucytosine was initiated. The patient's systemic symptoms and altered mentation subsequently resolved without sequelae.</p><p><strong>Conclusion: </strong>In patients receiving fingolimod who present with subacute altered mental status and severe hyponatremia, clinicians should maintain a high index of suspicion for cryptococcal meningitis and consider early cerebrospinal fluid evaluation, even in the absence of fever or meningeal signs.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"144"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary pulmonary artery synovial sarcoma: a case report.","authors":"Yun Xiao, Zhourui Liu, Sha Li","doi":"10.21037/acr-2026-0091","DOIUrl":"10.21037/acr-2026-0091","url":null,"abstract":"<p><strong>Background: </strong>Primary pulmonary artery synovial sarcoma (PPASS) is an extremely rare cardiac malignancy, often misdiagnosed preoperatively due to its nonspecific clinical and imaging features. This case report aims to enhance diagnostic recognition of this rare entity.</p><p><strong>Case description: </strong>A 35-year-old male presented with chest pain after activity for 1 month. Physical examination revealed stable vital signs and no significant cardiac murmurs. Laboratory tests showed negative immunofixation electrophoresis, unremarkable urinary light chains and coagulation function, and an N-terminal pro-B-type natriuretic peptide (NT-proBNP) level of 2,298 pg/mL. Transthoracic echocardiography (TTE) revealed an irregular solid mass (46 mm × 18 mm) at the pulmonary valve orifice, with a broad base and unclear border. Contrast-enhanced echocardiography showed mild perfusion within the mass. Cardiac magnetic resonance imaging and positron emission tomography/computed tomography (PET/CT) revealed atypical features [ill-defined borders and mild fluorodeoxyglucose (FDG) uptake], raising suspicion for malignancy. The patient underwent surgical resection of the cardiac tumor, pulmonary valvuloplasty, and tricuspid valvuloplasty. Intraoperatively, two distinct tumors were identified and resected. Postoperative pathology revealed a spindle cell tumor. Immunohistochemistry supported a diagnosis of biphasic synovial sarcoma, which was definitively confirmed by fluorescence in situ hybridization (FISH) demonstrating <i>SS18</i> gene rearrangement. The Ki-67 index was 60%. Six months post-surgery, imaging revealed local recurrence and lung metastases, and the patient received two cycles of ifosfamide, pirarubicin, and mesna chemotherapy with good tolerance.</p><p><strong>Conclusions: </strong>This case highlights the diagnostic challenges of PPASS, which can mimic myxoma on echocardiography. A broad base, unclear border, and atypical contrast perfusion should raise suspicion for malignancy. Definitive diagnosis relies on histopathology and molecular detection of SS18 rearrangement.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"138"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchoscopic lavage for pulmonary aspiration: a case series.","authors":"Tingting Wen, Bing Xiong, Chengjie Mei, Shengwen Song","doi":"10.21037/acr-2026-0085","DOIUrl":"10.21037/acr-2026-0085","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary aspiration of gastric contents is a life-threatening complication during anesthesia. Although immediate interventions are recommended, the role of bronchoscopic lavage remains controversial due to theoretical concerns about disseminating contaminants and limited clinical evidence.</p><p><strong>Case description: </strong>We present four illustrative cases of high-risk patients who underwent bronchoscopic lavage following large-volume aspiration of gastric fluid, solid material, or bile. All patients showed immediate improvement in oxygenation and reduction in airway pressure after bronchoscopic lavage, with a total of 250-700 mL of normal saline instilled into the affected lobar bronchi. None developed severe complications such as aspiration pneumonia, severe acute respiratory distress syndrome (ARDS), or death. Notably, one patient with pre-existing lung injury due to necrotizing pancreatitis also recovered favorably. In the two patients with available follow-up imaging, there was no radiographic evidence of bronchoscopic lavage -induced consolidation or diffused contamination.</p><p><strong>Conclusions: </strong>Prompt bronchoscopic lavage may be beneficial following large-volume aspiration, potentially through reducing inflammatory mediators and mechanically clearing particulate matter. Despite limitations inherent to its retrospective design and small sample size, this case series supports the safety and clinical utility of bronchoscopic lavage in this setting. Further large-scale studies are warranted to confirm these findings and establish standardized treatment protocols.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"126"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13467003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful resection of multi-focal lung nodules in a 53-year-old male following preoperative 5G-assisted remote robotic bronchoscopy dye marking: a case report.","authors":"Dingpei Han, Xinyi Wang, Wenbo She, Jiajun Ma, Fang Chen, Hecheng Li","doi":"10.21037/acr-2026-0031","DOIUrl":"10.21037/acr-2026-0031","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted bronchoscopy is an effective platform for transbronchial localization of pulmonary nodules before sublobar resection. However, access to this specialized technology and expertise is often limited to tertiary centers, creating geographic disparities in care. This case report describes the first clinical application of fifth-generation (5G)-assisted remote robotic bronchoscopy for preoperative dye marking, aiming to address this gap in surgical access and resource distribution.</p><p><strong>Case description: </strong>A 53-year-old asymptomatic male with two persistent ground-glass nodules [14 mm in the right upper lobe (RUL) and 7 mm in the right lower lobe (RLL)] was scheduled for resection. His medical history was unremarkable. Preoperative localization was performed using an artificial intelligence-enhanced robotic bronchoscopy system (Polaris^TM). The surgeon, operating from a remote console, successfully navigated to both lesions and injected indocyanine green at each site, with stable network latency of 21-24 milliseconds. Subsequent uniportal video-assisted thoracic surgery (VATS) wedge resection, guided by fluorescence imaging, was completed within 30 minutes with negligible estimated blood loss. Final pathology confirmed that the nodule in the RUL was atypical adenomatous hyperplasia (AAH), while that in the RLL was predominantly bronchiolar adenoma with a focal 2-mm non-mucinous adenocarcinoma in situ (AIS) component. The patient had an uneventful recovery and was discharged on postoperative day (POD) three.</p><p><strong>Conclusions: </strong>This initial case suggests the technical feasibility of 5G remote-controlled robotic bronchoscopy for preoperative localization. The ultra-low latency 5G network ensured real-time and precise control. This approach potentially expands access to specialized thoracic surgical expertise across geographical barriers. Its broader safety, efficacy, and clinical utility require validation in larger, prospective studies.</p>","PeriodicalId":29752,"journal":{"name":"AME Case Reports","volume":"10 ","pages":"139"},"PeriodicalIF":0.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}