Ryan Daniel John, McPhillips Dympna, Bruzzi John, Breen David
Department of Respiratory Medicine, University College Hospital Galway, Galway, Ireland.
BMJ Case Rep. 2014 Feb 23;2014:bcr2013202255. doi: 10.1136/bcr-2013-202255.
A 52-year-old female patient with a background history of malignant melanoma was referred to the interventional pulmonology unit at Galway University Hospital for the investigation of possible intrathoracic recurrence. A CT of the thorax (CT thorax) demonstrated mediastinal lymphadenopathy at position 4R, right paratracheal region. An endobronchial ultrasound (EBUS) revealed multiple enlarged lymph nodes at station 4R. The nodes were heterogeneous with solid and cystic elements. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) obtained a black material consistent with malignant melanoma. Multiple TBNA samples were obtained and the diagnosis was confirmed pathologically by the presence of multiple epithelioid pigmented cells on cell block analysis. This case report emphasises the value of EBUS in the assessment of metastatic disease and, in particular, how the gross appearance of the sample can be suggestive of the diagnosis.
一名有恶性黑色素瘤病史的52岁女性患者被转诊至戈尔韦大学医院介入肺病科，以调查可能的胸内复发情况。胸部CT显示右气管旁区域4R位置有纵隔淋巴结肿大。支气管内超声（EBUS）显示4R区有多个肿大淋巴结。这些淋巴结呈实性和囊性成分混合的异质性。支气管内超声引导下经支气管针吸活检（EBUS-TBNA）获取了与恶性黑色素瘤一致的黑色物质。获取了多个TBNA样本，细胞块分析显示存在多个上皮样色素沉着细胞，病理诊断得以证实。本病例报告强调了EBUS在评估转移性疾病中的价值，特别是样本的大体外观如何提示诊断。
