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Lung India. 2020 Jan-Feb;37(1):63-65. doi: 10.4103/lungindia.lungindia_187_19.

A novel procedure of endobronchial ultrasound-guided transbronchial needle aspiration for pulmonary parenchymal lesions: The ZUTAM technique.

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Consultant Pulmonologist, Department of Pulmonary Medicine, Santa Maria degli Angeli di Pordenone, Italy.
Senior Resident, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India.
Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.
Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India.


Convex probe-endobronchial ultrasound (CP-EBUS) has been proven to be safe and accurate for identifying malignancy and granulomatous disease affecting the mediastinum and hilum. CP-EBUS can be used for intraparenchymal lesions also and has been shown to be efficacious. A subset of lesions particularly suited for CP-EBUS are those completely surrounded by lung parenchyma, centrally located, and typically close to but without an airway leading directly to them. We report a case of transbronchial needle aspiration (TBNA) done from a nodule of size 11 mm in the superior segment of the right lower lobe. EBUS-TBNA was done from this lesion, which was 5 mm away from the bronchus in the lung parenchyma with intervening normal lung tissue in between. TBNA was performed by compressing the abutting normal lung tissue, thus causing compression collapse of the intervening normal lung. We labeled this Zealous Unique Trans Arterial Maneuver as the "ZUTAM" technique.


Bronchoscopy; Zealous Unique Trans Arterial Maneuver; cancer (lung); endobronchial ultrasound-guided transbronchial needle aspiration; parenchymal lesions

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