Lung Nodule with Increasing Fluorodeoxyglucose Uptake in a Patient with a History of Lung Carcinoma and Talc Pleurodesis Evaluated by EBUS-TBNA On-Site Assessment

2017 ◽  
Vol 61 (1) ◽  
pp. 84-86 ◽  
Author(s):  
Elizabeth M. Kurian
Keyword(s):  
New Left ◽  
Lung Nodule ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Talc Pleurodesis ◽  
Site Assessment ◽  
Fdg Uptake ◽  
Positron Emission ◽  
History Of ◽  
Site Evaluation

Background: Fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan is an indicator of potential malignancy or infection. Patients with a history of talc pleurodesis can develop pleural or lung parenchymal nodules/talcomas. In these patients, talc-associated (non-malignancy-related) FDG uptake may occur over years. Case Report: A 66-year-old female presented with a past medical history significant for resected non-small-cell lung cancer and was treated with chemotherapy/radiation. The referring physician indicated that she subsequently developed benign pleural effusions and had talc pleurodesis to limit recurrence. The patient was referred to our institution for endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBNA) due to a new left upper lobe nodule with increasing FDG uptake on follow-up interval PET performed at the referring institution. On-site cytologic evaluation showed no evidence of malignancy, but found refractile foreign material, consistent with the presence of talc particles. Conclusion: This case presents the importance of cytologic recognition of talc particles during on-site evaluation and discusses the phenomenon of increasing PET-FDG uptake associated with talc pleurodesis.

scholarly journals Sarcoid-like reaction associated with lung adenocarcinoma: A case report

2018 ◽  
Vol 28 (1) ◽  
pp. 68-70
Author(s):  
Qiao Li Tan ◽  
Leong Chai Leow ◽  
Salahudeen Mohamed Haja Mohideen ◽  
Duu Wen Sewa
Keyword(s):  
Lung Adenocarcinoma ◽  
Lower Lobe ◽  
Rare Condition ◽  
Disease Recurrence ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Transbronchial Needle Aspiration ◽  
Surveillance Imaging ◽  
Bilateral Hilar Lymphadenopathy ◽  
History Of

A 71-year-old woman with a history of left lower lobe lobectomy 4 years ago for adenocarcinoma of the lung presented with new mediastinal and bilateral hilar lymphadenopathy on surveillance imaging, suspicious for disease recurrence. She underwent an endobronchial ultrasound-guided transbronchial needle aspiration of the lymph nodes and histology yielded non-necrotizing epithelioid granulomas with no evidence of malignancy. A diagnosis of sarcoid-like reaction associated with lung adenocarcinoma was made. The significance of this rare condition is discussed.

Concordance Between Rapid On-Site Evaluation and Final Cytologic Diagnosis in Patients Undergoing Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Non-Small Cell Lung Cancer Staging

2019 ◽  
Author(s):  
Cristina Caupena ◽  
Lluis Esteban ◽  
Angels Jaen ◽  
Bienvenido Barreiro ◽  
Raquel Albero ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Staging ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Concordance Rate ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Site Evaluation ◽  
A Prospective Study

Abstract Objectives In patients with lung cancer undergoing mediastinal staging through endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), decisions are based on rapid on-site evaluation (ROSE) findings. We aimed to analyze the concordance rate between ROSE diagnosis and final diagnosis. Methods A prospective study was carried out in patients undergoing EBUS-TBNA for lung cancer staging. Diagnosis concordance was defined as cases where lymph nodes (LNs) presented the same diagnosis in ROSE and final diagnosis. Determinants of concordance were analyzed. Results Sixty-four patients were included and 637 LNs sampled. ROSE diagnosis was concordant with final diagnosis in 612 (96.1%) LNs and nonconcordant in 25 (3.9%). Differences in the concordance rate were found between pathologists, ROSE diagnoses, presence of cell block, number of passes, and number of slides. The staging status was changed between ROSE and the final diagnosis in three (4.6%) patients. Conclusions ROSE diagnosis has a high concordance with the final diagnosis.

scholarly journals Primary retroperitoneal mullerian adenocarcinoma

Rare Tumors ◽  
2010 ◽  
Vol 2 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Ayman Elnemr ◽  
Yutaka Yonemura ◽  
Masaya Shinbo ◽  
Eisei Nishino
Keyword(s):  
Abdominal Mass ◽  
Needle Aspiration ◽  
Cystic Mass ◽  
High Serum ◽  
Aspiration Cytology ◽  
Positron Emission ◽  
Pet Scanning ◽  
History Of ◽  
Needle Aspiration Cytology ◽  
Primary Retroperitoneal

Mullerian tumors are extremely rare malignancies in the retroperitoneum. We report a case of a 46-year old woman who presented with an eight year history of lower abdominal mass. Ultrasonography (US) and computed tomography (CT) demonstrated a 15×10 cm cystic mass in the left lower retroperitoneum. As serial percutaneous needle aspiration cytology was negative for malignancy, she was observed for seven years. Eleven months ago, the mass was excised. The histopathology was reported as mucinous adenocarcinoma of the retroperitoneum. Six cycles of intraperitoneal (IP) chemotherapy was administered during the last six months after diagnosis of recurrence by aspiration cytology and high serum tumor markers (CEA, CA19-9). A few days ago, positron emission tomographic (PET) scanning showed evidence of local recurrence and single vertebral metastasis, so she was admitted again for systemic chemotherapy. Meticulous revision of additional sections of the tumor revealed papillary, serous, mucinous, and endometrioid subtypes of the mullerian adenocarcinoma. To our knowledge, there has been no similar case described in the literature.

New advances in the management of pulmonary sarcoidosis

BMJ ◽  
2019 ◽  
pp. l5553 ◽  
Author(s):  
Daniel A Culver ◽  
Marc A Judson
Keyword(s):  
New Technologies ◽  
Granulomatous Inflammation ◽  
Needle Aspiration ◽  
Pulmonary Sarcoidosis ◽  
Endobronchial Ultrasound ◽  
Transbronchial Needle Aspiration ◽  
Optimal Outcomes ◽  
Disease States ◽  
Positron Emission ◽  
Immunosuppressive Medications

AbstractSarcoidosis is a highly variable granulomatous multisystem syndrome. It affects individuals in the prime years of life; both the frequency and severity of sarcoidosis are greater in economically disadvantaged populations. The diagnosis, assessment, and management of pulmonary sarcoidosis have evolved as new technologies and therapies have been adopted. Transbronchial needle aspiration guided by endobronchial ultrasound has replaced mediastinoscopy in many centers. Advanced imaging modalities, such as fluorodeoxyglucose positron emission tomography scanning, and the widespread availability of magnetic resonance imaging have led to more sensitive assessment of organ involvement and disease activity. Although several new insights about the pathogenesis of sarcoidosis exist, no new therapies have been specifically developed for use in the disease. The current or proposed use of immunosuppressive medications for sarcoidosis has been extrapolated from other disease states; various novel pathways are currently under investigation as therapeutic targets. Coupled with the growing recognition of corticosteroid toxicities for managing sarcoidosis, the use of corticosteroid sparing anti-sarcoidosis medications is likely to increase. Besides treatment of granulomatous inflammation, recognition and management of the non-granulomatous complications of pulmonary sarcoidosis are needed for optimal outcomes in patients with advanced disease.

Pitfalls and Key Features of a Case of Sclerosing Pneumocytoma: A Cytological Challenge?

2016 ◽  
Vol 60 (1) ◽  
pp. 85-88 ◽  
Author(s):  
Monica Onorati ◽  
Marta Nicola ◽  
Chiara Luisa Bianchi ◽  
Francesco Bini ◽  
Nadia Bellaviti ◽  
...  
Keyword(s):  
Lung Nodule ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Lung Tumour ◽  
Current Case ◽  
Sclerosing Hemangioma ◽  
Positron Emission ◽  
Key Features ◽  
Needle Aspiration Cytology ◽  
Tomography Scan

Background: The aim of the current case report is to re-evaluate the key features and pitfalls of fine-needle aspiration cytology (FNAC) in the diagnosis of sclerosing pneumocytoma (previously named sclerosing hemangioma) and to establish the importance of FNAC in addressing a proper surgical strategy. Case: Herein we documented a case of a 70- year-old man with a lung nodule which showed a hypermetabolic uptake on positron emission tomography. He therefore underwent FNAC under computed tomography scan guidance with a 22-gauge needle. The cytopathological examination allowed a diagnosis of sclerosing pneumocytoma. A wedge surgical excision was performed and the histological examination confirmed the cytological diagnosis. Conclusion: FNAC is a fundamental tool for distinguishing sclerosing pneumocytoma from a malignant lung tumour and together with clinical, radiological and pathological multidisciplinary assessment is indispensable in planning appropriate surgical management. Cytopathologists should be aware of the pitfalls and key features of the cytopathological diagnosis of sclerosing pneumocytoma, which can significantly change the surgical approach to the patient and protect him from aggressive overtreatment.

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