Tuberc Respir Dis.  2011 Nov;71(5):355-358.

Histopathologic Diagnosis of Pleural Metastasis of Renal Cell Carcinoma Using Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

• Kang YR
• Jhun BW
• Jeon K
• Koh WJ
• Suh GY
• Chung MP
• Kim H
• Kwon OJ
• Han J
• Um SW

Abstract

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful, safe diagnostic modality for evaluating mediastinal and hilar lymphadenopathy. We report a 51-year-old male who presented with a left renal mass and multiple pleural masses without lung parenchymal lesions. The pleural masses were thought to be metastatic tumors or malignant mesothelioma. The patient underwent two percutaneous needle biopsies of the pleural mass, but the specimens were insufficient for a histopathological diagnosis. Because one pleural mass was adjacent to the right main bronchus, we decided to perform EBUS-TBNA for the pleural mass. As a result, sufficient core tissue was obtained with no complications, and the histopathological findings were consistent with metastatic papillary renal cell carcinoma. To our knowledge, this is the first case of using EBUS-TBNA for a pleural mass.

Keyword

Biopsy, Fine-Needle; Ultrasonography; Pleura; Neoplasms; Carcinoma, Renal Cell

MeSH Terms

Biopsy, Fine-Needle
Biopsy, Needle
Bronchi
Carcinoma, Renal Cell
Humans
Lung
Lymphatic Diseases
Male
Mesothelioma
Middle Aged
Needles
Neoplasm Metastasis
Pleura

Figure

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  Figure 1 (A) Contrast-enhanced CT of the chest showing the pleural mass adjacent to the right main bronchus. (B) PET/CT shows hypermetabolic pleural masses. (C) EBUS reveals a heterogeneous low-echogenic pleural mass. (D) The transbronchial aspiration needle was inserted into the pleural mass under EBUS guidance. CT: computed tomography; PET: positron emission tomography; EBUS: endobronchial ultrasound.

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  Figure 2 (A) Histopathological examination of the core tissue shows papillae formation by cells with atypical nuclei (pleura, ×200). (B) The cells were immunoreactive for CD10, consistent with papillary renal carcinoma (CD10 stain, ×200).

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