Rosenblum Matthew K, Wang Sue X, Seeley Eric J
Division of Surgery, University of California San Francisco, San Francisco, CA, USA.
Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, CA, USA.
Respir Med Case Rep. 2017 Nov 10;23:18-20. doi: 10.1016/j.rmcr.2017.11.001. eCollection 2018.
We report findings for a patient that underwent endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) for diagnostic purposes after an abnormal chest CT. The patient initially presented with cough and shortness of breath. Chest CT revealed a 6 cm soft tissue mass with mildly enlarged right hilar lymph nodes (LNs) and a small right sided pleural effusion. Based on these radiologic findings, the patient underwent an EBUS guided FNA of the mass. To our surprise, the mass was hypoechoic by EBUS and on aspiration, the syringe filled with yellow fluid. This finding in combination with a re-review of the CT scans with a special focus on the Hounsfield Units of the lesion confirmed the diagnosis of a mediastinal bronchogenic cyst. This case demonstrates the role of Hounsfield units in analyzing mediastinal masses and highlights the effectiveness of EBUS guided TBNA in diagnosis and treatment of bronchogenic cysts.
我们报告了一名患者的检查结果，该患者在胸部CT异常后接受了支气管内超声（EBUS）引导下的经支气管针吸活检（TBNA）以进行诊断。患者最初表现为咳嗽和呼吸急促。胸部CT显示一个6厘米的软组织肿块，右侧肺门淋巴结轻度肿大，右侧有少量胸腔积液。基于这些影像学表现，患者接受了EBUS引导下对肿块的细针穿刺抽吸活检。令我们惊讶的是，EBUS显示肿块为低回声，抽吸时注射器中充满了黄色液体。这一发现结合对CT扫描的再次审视，特别关注病变的亨氏单位，证实了纵隔支气管源性囊肿的诊断。该病例展示了亨氏单位在分析纵隔肿块中的作用，并突出了EBUS引导下TBNA在支气管源性囊肿诊断和治疗中的有效性。
