METHOD OF OBTAINING BIOPSY SPECIMENS OF LYMPH NODES AND NEOPLASMS OF THE LUNGS AND MEDIASTINUM USING CRYOBIOPSY AFTER FINE NEEDLE PUNCTURE UNDER ENDOSONOGRAPHY CONTROL Russian patent published in 2023 - IPC A61B10/04 A61B8/08 A61B18/02 G01N23/46 

FIELD: medicine, oncology.

SUBSTANCE: before performing a surgical intervention, the volume of the mediastinal lesion, the size, shape and localization of foci or neoplasms of the lung parenchyma are visualized by the method of multislice computed tomography. The prevalence of the tumor process is assessed and target foci for biopsy are determined. Then, under conditions of general anesthesia in the position of the patient lying on his back, under the control of transbronchial ultrasonography using an echo-video bronchoscope with a convex sensor with a research frequency of 7–12 MHz, the puncture zone of the focus, neoplasm or lymph node in the mediastinum or in the lung is determined. A preliminary marking of the wall of the trachea or a large bronchus is performed and a channel is formed in the neoplasm by performing injections at the same point in the form of 4–7 series of reciprocating movements with a needle with a diameter of 19–22G connected to vacuum aspiration or fine needle aspiration to obtain a column of the tissue under study. Then the echo-video bronchoscope is replaced with a video bronchoscope and a cryoprobe with a diameter of 1.9 mm is inserted through the formed puncture channel to the depth of the puncture. After that, cryofixation of the tissue is carried out using a stream of liquefied gas for 3–7 seconds. A jerk and subsequent cryoextraction of the biopsy specimen as a single block with a video bronchoscope are performed in a volume sufficient for histological and immunohistochemical studies and subsequent molecular genetic tests for typing the neoplasm. At the same time, the process of tissue cryofixation with a jerk and subsequent cryoextraction of the biopsy in a single block is performed from 3 to 7 times. Carbon dioxide is used as the liquefied gas of cryoextraction.

EFFECT: method makes it possible to obtain a predetermined volume of a biopsy specimen for high quality histological assessment, to ensure the absence of an artifact of biopsy compression, to increase the diagnostic value of a histological examination, subsequent immunohistochemical examination and other analyses.

1 cl, 3 ex