Blizzard Sign as a specific endobronchial ultrasound image for ground glass opacity: A case report

Blizzard Sign as a specific endobronchial ultrasound image for ground glass opacity: A case report

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We report a case of lung adenocarcinoma presenting as pure ground glass opacity (GGO) and diagnosed by bronchoscopy with the use endobronchial ultrasound 2334-080 with a guide sheath (EBUS-GS).The lesion was indistinguishable by real-time fluoroscopy but simultaneous endobronchial ultrasound scanning of the involved lung segment showed a hyperechoic shadow that was subtly more intense than a typical 49ers gold hex code snowstorm appearance when scanning normal alveolar tissue.Transbronchial biopsy from this area revealed adenocarcinoma with lepidic growth.On hindsight, it was the aforementioned ultrasound pattern that helped us decide the sampling site for EBUS-GS guided TBB when fluoroscopy was equivocal.We hypothesize that this pattern is specific for GGO and we name it the Blizzard Sign.