Romanini Samuel Galante, Almeida Arthur Ferraz de, Castro Juliana Silveira Lima de, Serrano Juan Pablo Román, Torres Isabela Trindade, Ardengh José Celso
Department of Endoscopy Service, Hospital 9 de Julho, São Paulo, Brazil.
Santa Casa of São Paulo Medical School, São Paulo, Brazil.
Turk Thorac J. 2021 May;22(3):267-270. doi: 10.5152/TurkThoracJ.2021.20063.
Melanoma is an uncommon tumor and represents about 1.5% of all neoplasms. In the mediastinum, it presents as a primary neoplasm or metastasis. Diagnosis is essential for the adoption of the best therapy. Endosonography-guided fine needle aspiration (EUS-FNA) obtains cell samples and, when associated with other auxiliary exams such as immunohistochemistry, is useful to identify and differentiate primary and/or metastatic mediastinal lesions from a wide variety of other neoplasms. The endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) sensitivity is low and similar to endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNB) performed with the ProCore 25G or 22G needle. Thus, the diagnosis of this type of tumor becomes a great challenge. The authors report the first case in the literature of metastatic mediastinal melanoma derived from malignant cutaneous melanoma, which was submitted to Endosonography-guided fine needle biopsy (EUS-FNB) with the new ProCore 20G, to obtain tissue, being confirmed by histological examination of the specimens obtained with a single puncture.
黑色素瘤是一种罕见的肿瘤，约占所有肿瘤的1.5%。在纵隔中，它表现为原发性肿瘤或转移瘤。诊断对于采用最佳治疗方法至关重要。超声内镜引导下细针穿刺抽吸术（EUS-FNA）可获取细胞样本，当与免疫组织化学等其他辅助检查相结合时，有助于从多种其他肿瘤中识别和区分原发性和/或转移性纵隔病变。支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）的敏感性较低，与使用ProCore 25G或22G针进行的支气管内超声引导下经支气管针活检术（EBUS-TBNB）相似。因此，这类肿瘤的诊断成为一项巨大挑战。作者报告了文献中首例源自恶性皮肤黑色素瘤的转移性纵隔黑色素瘤病例，该病例接受了使用新型ProCore 20G的超声内镜引导下细针活检（EUS-FNB）以获取组织，通过对单次穿刺获取的标本进行组织学检查得以确诊。
