Abstract
Lung cancer is the leading cause of deaths from malignant neoplasms worldwide, and a satisfactory biopsy that allows for histological and other analyses is critical for its diagnosis. Guidelines have recommended endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) as the reference standard for the staging of lung cancer. However, the relatively limited sample volume retrieved by needle aspiration might restrict the diagnostic capacity of EBUS-TBNA in other uncommon thoracic tumors. Transbronchial mediastinal cryobiopsy is a recently developed sampling strategy for mediastinal lesions, which demonstrates added diagnostic value to conventional needle aspiration. Here, we present a case of thoracic SMARCA4-deficient undifferentiated tumor successfully diagnosed by mediastinal cryobiopsy additional to EBUS-TBNA.
Journal Section:
Novel Insights from Clinical Practice
References
1.
The American Thoracic Society and The European Respiratory Society
. Pretreatment evaluation of non-small-cell lung cancer
. Am J Respir Crit Care Med
. 1997
;156
:320
–32
.2.
Detterbeck
FC
, Jantz
MA
, Wallace
M
, Vansteenkiste
J
, Silvestri
GA
American College of Chest Physicians
. Invasive mediastinal staging of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition)
. Chest
. 2007
132
3 Suppl
202S
20S
.3.
Cameron
SEH
, Andrade
RS
, Pambuccian
SE
. Endobronchial ultrasound-guided transbronchial needle aspiration cytology: a state of the art review
. Cytopathology
. 2010
;21
(1
):6
–26
.4.
Zhang
J
, Fu
WL
, Huang
ZS
, Guo
JR
, Li
Q
, Herth
FJF
et al. Primary mediastinal seminoma achieved by transbronchial mediastinal cryobiopsy
. Respiration
. 2020
;99
(5
):426
–30
.5.
Huang
ZS
, Zhou
D
, Zhang
J
, Fu
WL
, Wang
J
, Wu
XL
et al. Mediastinal nodular lymphocyte predominant hodgkin lymphoma achieved by endoscopic transesophageal cryobiopsy
. Respiration
. 2022
;101
(2
):190
–4
.6.
Zhang
J
, Guo
JR
, Huang
ZS
, Fu
WL
, Wu
XL
, Wu
N
et al. Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: a randomised trial
. Eur Respir J
. 2021
;58
(6
):2100055
.7.
Zhang
J
, Huang
ZS
, Wu
XL
, Zhang
AM
, Fu
WL
, Liu
G
et al. Primary mediastinal large B-cell lymphoma achieved by non-cautery assisted transbronchial mediastinal cryobiopsy
. Respiration
. 2022
;101
(7
):683
–7
.8.
Fan
Y
, Zhang
AM
, Wu
XL
, Huang
ZS
, Kontogianni
K
, Sun
K
et al. Transbronchial needle aspiration combined with cryobiopsy in the diagnosis of mediastinal diseases: a multicentre, open-label, randomised trial
. Lancet Respir Med
. 2023 Mar
11
3
256
64
.9.
Varela-Lema
L
, Fernández-Villar
A
, Ruano-Ravina
A
. Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration: a systematic review
. Eur Respir J
. 2009
;33
(5
):1156
–64
.10.
Labarca
G
, Sierra-Ruiz
M
, Kheir
F
, Folch
E
, Majid
A
, Mehta
HJ
et al. Diagnostic accuracy of endobronchial ultrasound transbronchial needle aspiration in lymphoma. A systematic review and meta-analysis
. Ann Am Thorac Soc
. 2019
;16
(11
):1432
–9
.11.
Agrawal
A
, Ghori
U
, Chaddha
U
, Murgu
S
. Combined EBUS-IFB and EBUS-TBNA vs. EBUS-TBNA alone for intrathoracic adenopathy: a meta-analysis
. Ann Thorac Surg
. 2022 Jul
114
1
340
8
.12.
Perret
R
, Chalabreysse
L
, Watson
S
, Serre
I
, Garcia
S
, Forest
F
et al. SMARCA4-deficient thoracic sarcomas: clinicopathologic study of 30 cases with an emphasis on their nosology and differential diagnoses
. Am J Surg Pathol
. 2019
;43
(4
):455
–65
.13.
Kuwamoto
S
, Matsushita
M
, Takeda
K
, Tanaka
N
, Endo
Y
, Yamasaki
A
et al. SMARCA4-deficient thoracic sarcoma: report of a case and insights into how to reach the diagnosis using limited samples and resources
. Hum Pathol
. 2017
;70
:92
–7
.14.
Shi
L
, Lin
L
, Ding
Y
, Zeng
Y
, Chen
X
. Case report: a rapid response to immunotherapy in a thoracic SMARCA4-deficient undifferentiated tumor with respiratory failure
. Front Oncol
. 2022
;12
:1020875
.15.
Wahidi
MM
, Herth
F
, Yasufuku
K
, Shepherd
RW
, Yarmus
L
, Chawla
M
et al. Technical aspects of endobronchial ultrasound-guided transbronchial needle aspiration: CHEST guideline and expert panel report
. Chest
. 2016
;149
(3
):816
–35
.16.
Romatowski
NPJ
, Gillson
AM
, Stollery
D
, Dumoulin
E
, Vakil
E
, Dhaliwal
I
et al. Endobronchial ultrasound transbronchial needle aspiration with a 19-gauge needle vs 21- and 22-gauge needles for mediastinal lymphadenopathy
. Chest
. 2022
;162
(3
):712
–20
.17.
Manley
CJ
, Kumar
R
, Gong
Y
, Huang
M
, Wei
SS
, Nagarathinam
R
et al. Prospective randomized trial to compare the safety, diagnostic yield and utility of 22-gauge and 19-gauge endobronchial ultrasound transbronchial needle aspirates and processing technique by cytology and histopathology
. J Am Soc Cytopathol
. 2022
;11
(2
):114
–21
.© 2023 S. Karger AG, Basel
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2023
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