A case of renal cell carcinoma with mediastinal lymph node metastasis diagnosed by EBUS-TBNA / 대한내과학회지

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method of sampling mediastinal lymph nodes to aid in diagnosing lymphadenopathy and in staging metastatic cancers. This paper describes a case of renal cell carcinoma with mediastinal and hilar lymph nodes metastasis that was diagnosed using EBUS-TBNA. A 17-year-old woman who had mediastinal lymphadenopathy and a right renal mass underwent imaging studies. The results of a first EBUS-TBNA suggested malignancy, but the type of tumor and exact site of the primary tumor were uncertain. Therefore, we repeated EBUS-TBNA with a lower pressure on the vacuum syringe. We successfully diagnosed the mediastinal lymph node metastasis from renal cell carcinoma.

Comparison of Forcep-biopsy and Cryo-biopsy by a Flexible Bronchoscopy / 결핵및호흡기질환

BACKGROUND: A forceps-biopsy is performed to acquire tissue from patients with an endobronchial carcinoma using a flexible bronchoscope. Recently, a cryo-biopsy has also been used to acquire tissue samples. Cryo-biopsy is the diagnostic application of extreme cold for the local destruction of abnormal living tissue. This technique is safe, with no radiation danger, no risk of electrical accidents, and a little risk of bleeding. This study compared a forceps-biopsy with a cryo-biopsy using a flexible bronchoscope, and examined the chemosensitivity and level of VEGF (vascular endothelial growth factor) in the specimens obtained from the cryo-biopsy. METHODS: We present a prospective study of 30 consecutive patients who underwent a forceps-biopsy between January 2007 and October 2007 with a mean age of 62.1 years and a male:female ratio of 5 : 1. A flexible bronchoscope was inserted to the area of the abnormal lesions, and a cryo-probe was then applied through the working channel of the flexible bronchoscope. A temperature of approximately -80 was delivered to the tumor site for 8 seconds. The cryo-biopsy was performed after destroying the tumor mass. RESULTS: The mean size of the tissue from the forceps-biopsy and cryo-biopsy were 2.0+/-1.2 mm and 6.0+/-3.0 mm. A chemosensitivity test was performed on 5 specimens obtained using cryo-biopsy and the level of VEGF was examined in 2 specimens obtained from a cryo-biopsy. There were no side effects in either group. CONCLUSION: Cryo-biopsy using a flexible bronchoscope is a safe and effective technique for acquiring tissue samples.