--- title: "Electromag nav bronchoscopy saves drunken crab from surgery. | Sutter Health" description: "Used ENB to dx pulm infection, sparing pt unnec thoracotomy with lobectomy." url: "https://www.sutterhealth.org/research/publications/enb-saves-drunken-crab-fr-surgery-1055312421" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Electromag nav bronchoscopy saves drunken crab from surgery. # Electromagnetic navigational bronchoscopy spares a drunken crab from the surgeon's knife. Parikh MS, Seeley E, & Krishna G. _J Bronchology Interv Pulmonol. \[Epub ahead of print\]_ 2016-04-11 ## Abstract Surgical resection is traditionally the preferred treatment for fluorodeoxyglucose-avid peripheral pulmonary nodules that grow over time. However, new technologies, including electromagnetic navigational bronchoscopy (ENB), provide an opportunity to confirm or possibly exclude a cytologic cancer diagnosis, before resection. We present a case of a 56-year-old North American man who presented with a fluorodeoxyglucose-avid pulmonary nodule and sought a second opinion after being recommended thoracotomy with lobectomy. The peripheral nodule was biopsied using ENB and pathologic evaluation of the lesion demonstrated parasitic eggs with features of Paragonimus westermani. No evidence of malignancy was found. The radiographic abnormalities resolved after treatment with praziquantel. Using a minimally invasive procedure with ENB, we successfully diagnosed pulmonary infection with P. westermani, a rare infectious cause of peripheral pulmonary lesions in a patient without travel to an endemic area. Furthermore, an alternative diagnosis to cancer was established, sparing this patient an unnecessary thoracotomy with right middle lobectomy. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/27070338) ![Ganesh Krishna, M.D., FCCP](https://dyn.mktgcdn.com/p/7HZoN6h0d4phO4VQYcU6TE-_Cn72_cBpIS3NRGru51E/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Ganesh Krishna, M.D., FCCP Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/ganesh-krishna-md-fccp-1049681082) ## Research topics - [Lung Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Lung+Diseases%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Update on the treatment of lymphangioleiomyomatosis.](https://www.sutterhealth.org/research/publications/update-treatment-lymphangioleiomyomatosis-1055312862) Krishna G, Berry G, Kao P, Rosen G, Raffin TA. Clin Pulmon Med. 6(2):126-132. 1999 Mar 01 - Publication ### [Parasitic pulmonary eosinophilia.](https://www.sutterhealth.org/research/publications/parasitic-pulmonary-eosinophilia-1055312949) Chitkara RK, Krishna G. Semin Respir Crit Care Med. 27(2):171-84. 2006 Apr 01 - Publication ### [Advances in the management of chronic obstructive pulmonary disease.](https://www.sutterhealth.org/research/publications/advances-mgmt-copd-1055312934) Meinke L, Chitkara R, Krishna G. Expert Opin Pharmacother. 8(1):23-37. 2007 Jan 01 - Publication ### [A 35-year-old man with fever, dyspnea, and diffuse reticular opacities.](https://www.sutterhealth.org/research/publications/35-yo-man-fever-dyspnea-reticular-oopacities-1055312816) Katikireddy CK, Krishna G, Keifer T, Kuschner W, Rosen G. Chest. 129(2):482-7. 2006 Feb 01 - Publication ### [A 24-year-old woman with bilateral pulmonary infiltrates, pericardial effusion, and bilateral pleural effusions.](https://www.sutterhealth.org/research/publications/24-yo-woman-pulmonary-infiltrates-effusions-1055312831) Katikireddy CK, Krishna G, Berry G, Faul J, Kuschner W. Chest. 128(6):4013-7. 2005 Dec 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/enb-saves-drunken-crab-fr-surgery-1055312421#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Electromag nav bronchoscopy saves drunken crab from surgery."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/enb-saves-drunken-crab-fr-surgery-1055312421#medicalscholarlyarticle","name":"Electromagnetic navigational bronchoscopy spares a drunken crab from the surgeon's knife.","headline":"Electromag nav bronchoscopy saves drunken crab from surgery.","abstract":"Surgical resection is traditionally the preferred treatment for fluorodeoxyglucose-avid peripheral pulmonary nodules that grow over time. 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