Page 51 - ECBIP 2021_Program

MODERATED e-POSTER SESSION 03:
EBUS Bronchoscopy
PP16
Introduction: Retrotracheal lymph nodes are seldom identified. Both endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and esophageal ultrasound-guided needle aspiration (EUS-NA) can reach this central and otherwise inaccessible location.
Case Report: A 56-year-old woman with previous history of low tobacco exposure (4 pack-years) and valvular atrial fibrillation under anticoagulation, presents with intense back pain, asthenia, weight loss, night sweats and orthopnea. Physical examination and chest radiograph revealed no abnormality.The patient underwent chest computed tomography to exclude aortic dissection that incidentally identified a 23mm retrotracheal mass in the superior mediastinum. Subsequently, she was then referred to the Pulmonology Department to undergo endobronchial ultrasound. A conglomerate of lymph nodes was identified in the 3P station via EBUS (figure 1) and EUS-b (figure 2).
The biggest lymph node in the conglomerate had a smaller axis of 19mm, with apparently preserved normal node anatomy. EBUS-TBNA and EUS-NA were performed, collecting hematocellular material that was sent for histological and microbiological examination. Pathology identified malignant lymphadenopathy due to squamous cell carcinoma of unknown origin. Negative microbiology of bronchial secretions and lymph node aspirate excluded infection. Back pain was attributed to vertebral degenerative disease.
Conclusion: Lesions in the retrotracheal mediastinal station 3P are easily accessible for sampling using endoscopic ultrasound via the trachea or the esophagus,whereas it is impossible through other methods like mediastinoscopy.The usability and the effortlessness of needle aspiration through the posterior tracheal or esophageal walls make EBUS-TBNA and/or EUS-NA the ideal approach to 3P lesions, as documented in this case report.
Figure 1: Endobronchial ultrasound, Station 3P: Retrotracheal mass
Figure 2: Esophageal ultrasound with broncoscope, Station 3P: Retrotracheal mass.
COMBINED EBUS AND EUS-B FOR THE DIAGNOSIS OF RETROTRACHEAL MASS
Gonçalo Samouco, Luís Vaz Rodrigues
Serviço De Pneumologia, ULS Guarda, Guarda, Portugal
ECBIP 2021 51
6th European Congress
for Bronchology and Interventional Pulmonology
OCTOBER ECBIP 15 - 17
ATHENS - GREECE 2021
Book of Abstracts