Tuberc Respir Dis.  2013 Feb;74(2):74-78.

Malignant Pleural Mesothelioma Diagnosed by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

• Kang B
• Kim MA
• Lee BY
• Yoon H
• Oh DK
• Hwang HS
• Choi C

Abstract

A 61-year-old woman came to the hospital with dyspnea and pleural effusion on chest radiography. She underwent repeated thoracentesis, transbronchial lung biopsy, bronchoalveolar lavage, and thoracoscopic pleural biopsy with talc pleurodesis, but diagnosis of her was uncertain. Positron emission tomography showed multiple lymphadenopathies, so she underwent endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal lymph nodes. Here, we report a case of malignant pleural mesothelioma that was eventually diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration. This is an unusual and first case in Korea.

Keyword

Mesothelioma; Diagnosis; Bronchoscopy; Ultrasonography; Lymph Nodes

MeSH Terms

Biopsy
Bronchoalveolar Lavage
Bronchoscopy
Dyspnea
Female
Humans
Korea
Lung
Lymph Nodes
Mesothelioma
Needles
Pleural Effusion
Pleurodesis
Porphyrins
Positron-Emission Tomography
Talc
Thorax
Porphyrins
Talc

Figure

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  Figure 1 Multiple air-fluid levels and consolidation were seen on chest radiography (A) and chest computed tomography (B).

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  Figure 2 Positron emission tomography computed tomography showed multiple high uptake lesions, and endobronchial ultrasound-guided transbronchial needle aspiration was done on right upper paratracheal (A, D), subcarinal (B, E), and right interlobar (C, F) lymph nodes.

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  Figure 3 Pathologic findings obtained by endobronchial ultrasound-guided transbronchial needle aspiration. Papillary clusters of epithelioid cells (H&E stain, A, ×100; B, ×400), positive for anti-calretinin antibody (C, ×400), negative for anti-thyroid transcription factor-1 antibody (D, ×400), positive for cytokeratin 5/6 (E, ×400) and weak, but definitive Wilms tumor 1 (F, ×400).

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