Highlights
- •Hydrogel plugs used after lung biopsies will likely be encountered more frequently.
- •It is important to know the imaging and histological appearance of hydrogel plugs.
- •On imaging, hydrogel plugs are described as linear, serpiginous or lobular.
- •On histology, hydrogel plugs are described as foamy or mesh-like.
- •Hydrogel plugs did not affect tumor staging.
Abstract
Purpose
To summarize imaging and histopathologic characteristics of hydrogel sealant (plug)
in lung parenchyma and assess their correlation with time since deployment of sealant.
Materials and methods
Among a total of 208 participants randomized to the hydrogel sealant arm of a lung
biopsy prospective randomized clinical trial, 51 underwent resection of the biopsied
lesion. In 34 participants sealant material was present on histopathologic sections
(n = 22), or they had cross-sectional imaging of chest between biopsy and resection
(n = 23) or they had both imaging and histopathology (n = 11). Histopathologic and imaging findings were described. The association of these
findings with time since sealant deployment was evaluated using the Wilcoxon rank
sum test.
Results
The mean time since sealant deployment for histopathology was 45.7 days (median 36,
range 14–181) and for imaging studies was 99 days (median 32, range 4–527). The sealant
was infiltrated by inflammatory cells in 20 (91%) participants. The main general histopathologic
pattern of sealant was foamy in 12 (57%) and mesh in 8 (38%) participants. Imaging
appearance of sealant was serpiginous in 18 (60%), linear in 10 (33%) or lobulated
in 2 (6.7%) participants. In 2 participants the sealant was hypermetabolic with no
histopathologic evidence of tumor. No correlation was found between time since sealant
deployment and imaging or histopathologic appearances.
Conclusion
Hydrogel sealant appears as a serpiginous, linear, or lobulated opacity on cross-sectional
imaging which can be metabolically active. It is associated with an inflammatory reaction
with a foamy or mesh general pattern on histopathological assessment. No correlation
was found between time since sealant deployment and imaging or histopathologic appearances.
Keywords
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Article info
Publication history
Published online: December 26, 2022
Accepted:
December 13,
2022
Received in revised form:
November 30,
2022
Received:
April 10,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
