A Case of Primary Lung Cancer Developed Air Embolism due to CT-guided Percutaneous Needle Biopsy of the Lung

Abstract

A 78-year-old man presented with an abnormal shadow on a chest x-ray film taken for preoperative examination of spinal disc herniation. A chest CT scan revealed a 3-cm tumor in the right lower lobe of lung. A CT-guided percutaneous needle biopsy of the lung confirmed that his consciousness level had declined, and the circulatory dynamics became unstable. Following CT scanning, he was diagnosed with air embolism (the brain and the heart), and we started intubation and mechanical ventilation. His cardiac function recovered quickly and a therapy according to cerebral infarction was started for air embolism of the brain by a neurologist in the hospital. Rehabilitation was started on and after the 4^th hospital day and the intubated tube was removed on the 11^th hospital day. We confirmed that he had dysphagia and dyskinesis of the left arm, so that percutaneous endoscopic gastrostomy was performed on the 35^th hospital day. As a result of a lung biopsy, he was diagnosed with squamous cell carcinoma of the right lower lobe of lung (T2aN0M0, Stage IB). When he started to take a dysphagia diet and became possible to walk with a stick, he and his family hoped to undergo surgery for lung cancer and thoracoscopic partial resection of the right lower lobe was performed on the 56^th hospital day. His postoperative course was uneventful and he was discharged home on the 88^th hospital day.