title: Initial Diagnosis of Mediastinal Lymph Node Metastases From Prostate Cancer by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration.
abstract: A 61-year-old patient with multiple enlarged mediastinal and hilar lymph nodes (♯3a, ♯4R, ♯7, and ♯11) and no abnormal shadows in the lung field by chest computed tomography was referred to our department for further evaluation. Endobronchial ultrasound-guided transbronchial needle aspiration was performed; cytology revealed adenocarcinoma, whereas histology contained adenocarcinoma of prostate origin. Immunohistochemistry was strongly positive for prostate-specific antigen and prostate-specific acid phosphate for confirmation of metastases from the prostate cancer and negative for thyroid transcription factor-1. Hence, the patient was diagnosed as having lymph node metastasis from a prostate cancer. After the initial diagnosis, needle biopsy of the prostate was performed, and prostate cancer was confirmed. The patient received hormonal therapy and has remained in stable condition. Endobronchial ultrasound-guided transbronchial needle aspiration provides tissue for histologic examination, including immunohistochemistry, from mediastinal and hilar lymph nodes involved with metastasis from a distal primary site.
authors.affiliation: Departments of *Thoracic Surgery and ‡Diagnostic Pathology, Graduate School of Medicine, Chiba University, Chiba †The Thoracic Oncology Division of National Cancer Center East Hospital, Kashiwa, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Tochigi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yasufuku
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakajima
authors.forename: Taiki
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kubota
authors.forename: Youko
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshino