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Procedures: Procedures: Bronchology |

Transarterial EBUS-TBNA in the Diagnosis of Hilar Lesions

Noelia Cubero, MD; Matt Salamonsen, MD; Rosa Lopez Lisbona, MD; Jordi Dorca, MD; Antoni Rosell, MD
Author and Funding Information

Hospital Universitari Bellvitge, Barcelona, Spain


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A427. doi:10.1016/j.chest.2016.02.445
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SESSION TITLE: Procedures: Bronchology

SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, April 17, 2016 at 11:45 AM - 12:45 PM

INTRODUCTION: Obtaining tissue diagnosis from a lung tumor or a mediastinal lymph node located adjacent to the aorta or pulmonary artery has been conventionally regarded as a diagnostic challenge.

CASE PRESENTATION: We present the case of a 51 year old man, with a history of metastatic rectal adenocarcinoma, (cT2N3M1 with liver metastasis). A PET-TC showed a PET positive left hilar lesion. Evaluation by a multidisciplinary tumor board, decided that the lesion was suspicious of malignancy and warranted further investigation to differentiate metastasis versus primary lung cancer. An EBUS procedure was performed and an anechoic structure was seen between the left main bronchial wall and the target node. This was the only window to visualize the lesion. Doppler examination confirmed flow within the hypoechoic structure, which along with the location allowed it to be positively identified as the pulmonary artery. TBNA of the node was performed with a 22 G needle. Final cytological examination of the sample showed metastatic rectal adenocarcinoma.

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