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Review
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Korean J Med. 2006;71(1):204-204.
- Endoscopic ultrasonography-guided fine needle aspiration for the metastatic mediastinal lymph node in recurrent lung cancer
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Hansoo Kim, Su-Jin Chung, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, In Sung Song
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아주대학교 의과대학 호흡기내과
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- Abstract
- The biopsy is required to confirm or rule out metastasis in PET-positive lymph node (LN) due to the low specificity of PET.
Currently, invasive surgical technique such as mediastinoscopy or mediastinotomy is the standard procedure to obtain LN tissue.
It is desirable to perform the minimally invasive methods in sampling suspicious LN. Here we are reporting the successful
EUS-guided FNA for the diagnosis of CT-negative and PET-positive LN after curative resection in lung cancer. To the best
of our knowledge, this is believed to be the first description in Korea to perform EUS-FNA for the evaluation of metastatic LN
during the follow-up. A 63-years old male patient was diagnosed non-small lung cancer with the stage of T4N0M0.
VATS-aided left upper lobectomy with mediastinal lymph node dissection was performed, and the patient has been free of any
recurrent tumor or lymph node for the next 1 year. The serum level of CEA increased up to 7.8 ng/ mL during his routine
follow-up, but CT failed to show any suspicious lesions. PET-CT was done to evaluate the possible metastatic or recurrent
tumor, whish revealed the hypermetabolic lesion in paraesophageal lymph node. Therefore, we performed EUS-guided FNA for
sampling the paraesophageal lymph node, which proved the metastatic adenocarcinoma. In conclusion, EUS-FNA provided
minimally invasive confirmation of the metastatic LN in recurrent lung cancer after curative resection. Therefore, EUS-FNA
should be considered in any patient with suspicious metastatic LN to confirm or rule out the metastasis.
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