Usefulness of an Acquire Endobronchial Ultrasound-transbronchial Needle Biopsy in the Diagnosis of Mediastinal and Hilar Lymph Node Metastasis from Renal Cell Carcinoma in a Patient with Triple Cancer

• Published in: The Journal of the Japan Society for Respiratory Endoscopy Vol. 44; no. 4; pp. 273 - 278
• Main Authors: Miyahara, Nobuaki, Nakajima, Yasuhiro, Takigawa, Nagio, Minami, Daisuke, Kanehiro, Arihiko
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society for Respiratory Endoscopy 25.07.2022; 特定非営利活動法人 日本呼吸器内視鏡学会
• Subjects: Acquire™ Pulmonary; EBUS-TBNB; Next-generation sequencing; Renal cell carcinoma; アクワイヤー超音波内視鏡下穿刺針; 次世代シーケンシング; 腎癌
• ISSN: 0287-2137; 2186-0149
• DOI: 10.18907/jjsre.44.4_273

Background. Endoscopic ultrasound fine-needle aspiration with an Acquire needle is useful for diagnosing pancreatic cancer, gastrointestinal stromal tumor and intraperitoneal lymph node metastasis. Case. A 78-year-old man had mediastinal and hilar lymphadenopathy on positron emission tomography computed tomography (PET-CT). Gastric, prostate and renal cancers were strongly suspected based on upper gastrointestinal endoscopy and PET-CT findings. We performed an Acquire endobronchial ultrasound-transbronchial needle biopsy (EBUS-TBNB), collecting samples of lymph nodes through the bronchus. Immunohistochemical staining of the specimen, which was negative for TTF-1 and positive for CA9, lead to the diagnosis of lymph nodes metastasis from clear cell renal cell carcinoma. Furthermore, the sample obtained by an additional puncture was sufficient to carry out next-generation sequencing (amount of nucleic acid: DNA 952 ng and RNA 240 ng). Conclusion. An Acquire EBUS-TBNB was useful for obtaining an adequate sample volume.