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Clinical Image
Diagnosis of intrathoracic uterine leiomyosarcoma metastasis by endobronchial ultrasound-guided transvascular biopsy
Diagnóstico de metástasis intratorácica de leiomiosarcoma uterino mediante punción transvascular guiada por ecobroncoscopia
Blanca de Vega Sáncheza,c,
Corresponding author
blancadevegasanchez@gmail.com

Corresponding author.
, Carlos Disdier Vicentea,d, Henar Borrego Pintadob
a Unidad de Broncoscopias y Técnicas Pleurales, Servicio de Neumología, Hospital Clínico Universitario Valladolid, Valladolid, Spain
b Servicio de Anatomía Patológica, Hospital Clínico Universitario Valladolid, Valladolid, Spain
c Grupo Emergente de Broncoscopia y Neumología Intervencionista (GEBRYN) de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
d Centro de Investigación en Red Enfermedades Respiratorias (CIBERES), Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 59-year-old woman with a diagnosis of uterine leiomyosarcoma &#40;T1bN0&#44; stage IB&#41; undergoing hysterectomy and double adnexectomy&#44; referred for profiling of right hilar adenopathy &#40;corresponding to lymph node station 11R&#41; of pathological appearance in a computed axial tomography performed during oncological follow-up &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Once the patient had been fully informed&#44; endobronchial ultrasound was performed&#44; and a single lymphadenopathy measuring 12&#46;2&#8239;&#215;&#8239;14&#8239;mm was found in lymph node station 11R&#46; Given the presence of ultrasound characteristics predictive of malignancy<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> &#40;hypoechoic appearance&#44; homogeneous&#44; rounded shape&#44; presence of easily distinguishable margins&#44; and absence of hilar center &#91;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#93;&#41;&#44; we performed a 2-pass transvascular puncture &#40;EBUS-TVNA&#41; using a Cook medical needle ECHO-HD-22-EBUS-P&#174;&#44; with a 5&#8239;cm aspiration&#44; with no immediate complications &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41;&#46; Cytohistological diagnosis of the lesion demonstrated the presence of fusiform cells with hyperchromatic elongated nuclei&#44; marked atypia and cell expression of specific muscle actin&#44; histologically consistent with leiomyosarcoma metastases &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figs&#46; 1</a>D and E&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Although the use of this approach is rare&#44; EBUS-TVNA has demonstrated a 71&#37; yield in units with extensive experience in endoscopic lymphadenopathy management and the absence of major complications requiring subsequent therapeutic interventions<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; In spite of the limited information available in the literature&#44; this technique should be considered as a diagnostic method provided that the appropriate physical infrastructure and personnel are on hand to mitigate possible complications&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; de Vega S&#225;nchez B&#44; Disdier Vicente C&#44; Borrego Pintado H&#46; Diagn&#243;stico de met&#225;stasis intrator&#225;cica de leiomiosarcoma uterino mediante punci&#243;n transvascular guiada por ecobroncoscopia&#46; Arch Bronconeumol&#46; 2021&#59;57&#58;765&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#41; Computed tomography image with adenopathy in right hilar lymph node station&#46; B&#41; Image of lymph node station 11R from endobronchial ultrasound&#46; C&#41; Transvascular puncture by endobronchial ultrasound&#46; D&#41; Histological image at amplification &#215;20 of hematoxylin-eosin staining showing spindle cell proliferation with atypical forms&#46; E&#41; Histological image at amplification &#215;20 showing positivity for specific muscle actin&#46;</p>"
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                      "autores" => array:1 [
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Article information
ISSN: 15792129
Original language: English
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