Page 61 - ECBIP 2021_Program

MODERATED e-POSTER SESSION 04:
Central airways obstruction and foreign body extraction
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Introduction: The role of EBUS-TBNA in diagnosis of hilar and mediastinal lymphadenopathies is well known: in particular it represents an excellent tool in diagnosis and staging of lung cancer. International Guidelines suggest EBUS-TBNA as a first step in ruling in and out lymph node metastasis in patients with lung cancer in case of hilar and/or mediastinal lymph node enlargement on CT scan and/or fluoro-dessossi-glucose positrone emission tomography (FDG-PET) positive lymphadenopathies.
Case Report: A 74 years-old male patient with a recent history of right upper lobectomy for adenocarcinoma (August 2020) was referred to our Interventional Pulmonology Unit six months after surgery for the CT scan appearance of a right inferior paratracheal (station 4R) lymph node enlargement.The lymph node was intensely FDG-PET positive (standardized uptake value - SUVmax 5.4) and highly suggestive of metastasis (Fig.1). EBUS-TBNA was performed and, surprisingly, the cyto-pathological evaluation did not reveal atypical cells, rather showing amorphous acellular eosinofilic material mixed to an inflammatory reaction (Fig.2).The acellular component resulted to be part of the oxidized regenerated cellulose product (“Tabotamp”) used to obtain bleeding control during the previous chest surgery.The cellulose fibers migrated through lymphatic vessels reaching right paratracheal lymph node and generating a foreign body granulomatous lymphadenitis.
Discussion: PET-CT scan is an excellent tool for the clinical diagnosis and staging of lung neoplasms and it plays an important role in the follow-up of patients to identify relapse of the disease.However,the possibility of benign conditions with inflammatory activity that may induce a false-positive high SUV on FDG-PET,should always be considered in cancer patients.The appearance of a new hypermetabolic lymphadenopathy during a lung cancer follow-up is not always synonymous of recurrence, so that the histological confirmation must be considered mandatory in order to establish the best therapeutic strategy. In patients who underwent surgery for lung cancer, the development of lymph node foreign body reaction due to surgical material retention,even if rare,should always be considered. This case report reiterates the need to obtain cytohistological confirmation of PET-FDG positive lymph nodes in cancer patients and further underlines the essential role of EBUS-TBNA in the diagnostic work up and follow-up of lung cancer.
A STRANGE MEDIASTINAL FOREIGN BODY REACTION MIMICKING NODAL METASTASIS: A CASE REPORT
Maria Agnese Latini1,2, Francesca Gonnelli1,2, Lina Zuccatosta2, Stefano Gasparini1
1 Department of Biomedic Sciences and Public Health, Polytechnic University of Marche Region, Ancona, Italy 2 Pulmonary Diseases Unit, Azienda “Ospedali Riuniti”, Ancona, Italy
Figure 1: Positron emission tomography/computed tomography showing right inferior paratracheal adenopathy with increased metabolic activity.
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Figure 2: Lymphadenopathy cytology showing amorphous acellular eosinofilic material mixed to an inflammatory reaction
WITHDRAWN
ECBIP 2021 61
6th European Congress
for Bronchology and Interventional Pulmonology
OCTOBER ECBIP 15 - 17
ATHENS - GREECE 2021
Book of Abstracts