Fig. 2

Representative case of transbronchial cryobiopsy using the two-scope technique for a peripheral pulmonary lesion. Computed tomography evaluation of an 82-year-old woman showing a part-solid ground-glass nodule (GGN) in the right upper lobe. CT shows it is located at right S3 (a). The target lesion is approached using a thin scope guided by virtual bronchoscopy displaying the bronchus route “B3aiiαy” toward the target lesion (b). Radial endobronchial ultrasound (R-EBUS) showing a blizzard sign (c). The biopsies using forceps and cryoprobe are performed with reference to fluoroscopy and R-EBUS imaging (d). Cryobiopsy causes moderate bleeding that is stopped using bronchoscopic suctioning in 2 min (e). Adenocarcinoma is revealed by only the cryobiopsy specimen (hematoxylin–eosin stain, × 200) (f)