A Case of Diffuse Large B-Cell Lymphoma Successfully Diagnosed Using Multiple Modalities to Evaluate Specimens From Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration
- VernacularTitle:縦隔リンパ節結核との鑑別を要しEBUS－TBNA検体のセルブロックとフローサイトメトリーが診断に有用であったびまん性大細胞型B細胞性リンパ腫の1例
- Author:
Ryosuke KINOSHITA
1
;
Makoto NAKAO
1
;
Saori TOMITA
1
;
Syuntaro HAYASHI
1
;
Masahiro SUGIHARA
1
;
Yuya HIRATA
1
;
Sosuke ARAKAWA
1
;
Mamiko KURIYAMA
1
;
Kohei FUJITA
1
;
Kazuki SONE
1
;
Yu ASAO
2
;
Hideki MURAMATSU
1
Author Information
- From:Journal of the Japanese Association of Rural Medicine 2022;70(6):643-648
- CountryJapan
- Language:Japanese
- Abstract: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is useful for diagnosing mediastinal lymph node lesions. Cell blocks prepared from the needle washing fluid and flow cytometry of tissue samples are helpful in making the diagnosis, but the combination of both examinations is not routinely performed. A 77-year-old woman with fever, dyspnea, and anorexia was admitted to our hospital. Computed tomography showed enlarged mediastinal lymph nodes with calcification and left ureteral calculus; however, no focus of infection was identified. We suspected lymph node tuberculosis or malignant lymphoma, and EBUS-TBNA was performed to evaluate the mediastinal lymph node lesions. Because a cell block prepared from the needle rinse fluid was suspicious for malignant lymphoma, we changed the puncture needle from 22 G to 19 G and performed a second EBUS-TBNA. Diffuse large B-cell lymphoma (DLBCL) was diagnosed based on the results of flow cytometry of the EBUS-TBNA samples. Here we report this case of DLBCL in which mediastinal lymph node tuberculosis was suspected and cell block preparation and flow cytometry using EBUS-TBNA specimens were useful for the diagnosis.
