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中华肺部疾病杂志(电子版) ›› 2023, Vol. 16 ›› Issue (05) : 755 -756. doi: 10.3877/cma.j.issn.1674-6902.2023.05.042

病例报告

经EBUS-TBNA诊断肾透明细胞癌纵膈淋巴结转移一例
张晓飞, 许慧芬, 韩开宇()   
  1. 150000 黑龙江,哈尔滨医科大学第二附属医院呼吸与危重症医学科
  • 收稿日期:2023-04-03 出版日期:2023-10-25
  • 通信作者: 韩开宇

One case of mediastinal lymph node metastasis of renal clear cell carcinoma by EBUS-TBNA

Xiaofei Zhang, Huifen Xu, Kaiyu Han()   

  • Received:2023-04-03 Published:2023-10-25
  • Corresponding author: Kaiyu Han
引用本文:

张晓飞, 许慧芬, 韩开宇. 经EBUS-TBNA诊断肾透明细胞癌纵膈淋巴结转移一例[J]. 中华肺部疾病杂志(电子版), 2023, 16(05): 755-756.

Xiaofei Zhang, Huifen Xu, Kaiyu Han. One case of mediastinal lymph node metastasis of renal clear cell carcinoma by EBUS-TBNA[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2023, 16(05): 755-756.

纵膈的解剖结构复杂,内部器官较多,组织来源各异,是多种良、恶性病变的好发部位。随着影像学技术的发展,纵膈淋巴结肿大已成为常见的临床征象,其已知病因包括结节病、结核、恶性肿瘤、炎症等[1,2,3]。但由于无特征性的临床表现和影像学改变,疾病诊断的难度较大。超声内镜引导下的经支气管针吸活检技术(endobronchial ultrasound-guided transbronchial needle aspiration, EBUS-TBNA)是一种有力的诊断工具,对于纵膈淋巴结的诊断、安全率高[4,5,6]。多项研究表明,EBUS-TBNA的敏感性和特异性分别为90%~93%和99~100%,而并发症的发生率仅为1.23%~1.44%[7,8]。本文报道1例既往无任何疾病的先天性肾脏结构异常患者,因纵膈淋巴结肿大就诊,通过EBUS-TBNA,结合全身PET-CT检查,最终诊断为肾透明细胞癌纵膈淋巴结转移,报道如下。

图1 影像学表现。注:A:纵膈多组淋巴结肿大;B:PET-CT提示:左肾下极混杂密度肿块,大小约59.1 mm×55.1 mm,FDG代谢轻度增高,考虑恶性病变,肾癌可能;C:左肾异位,马蹄肾
图2 HE染色和免疫组化图片。注:A:HE染色:在正常细胞的背景下存在癌细胞的组织碎片(放大倍数×100);B:EMA染色阳性(放大倍数×400);C:CD10染色阳性(放大倍数×400);D:CAIX染色阳性(放大倍数×400)
1
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