title: The Intranodal Presence of Coexisting Granulomatous Inflammation and Carcinoma During Transbronchial Needle Aspiration of Intrathoracic Lymphadenopathy.
abstract: The presence of intrathoracic lymphadenopathy in patients with suspected malignancy remains concerning, often prompting further evaluation with tissue sampling. The presence of nodal granulomatous inflammation in patients with underlying malignancy is well reported. However, review of 3 recent large trials of endobronchial ultrasound-guided transbronchial needle aspiration in patients with granulomatous inflammation and malignancy did not identify the presence of coexisting, intranodal malignancy, and granulomatous inflammation, rather these diagnoses remained nodally exclusive. We present a case of coexisting granulomatous inflammation and metastatic carcinoma within the same lymph node aspirates, reviewing the potential diagnostic pitfalls and implications of this rare occurrence.
authors.affiliation: *Swedish Cancer Institute/Swedish Medical Center, Division of Thoracic Surgery and Interventional Pulmonology, Seattle, WA †Department of Pathology, Penn State College of Medicine-Milton S. Hershey Medical Center, Hershey, PA ‡The Johns Hopkins University School of Medicine, Division of Pulmonary and Critical Care Medicine, and Interventional Pulmonology, Baltimore, MD.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Gilbert
authors.forename: Catherine
authors.initials: C
authors.lastname: Abendroth
authors.forename: Lonny B
authors.initials: LB
authors.lastname: Yarmus
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D000072281:Lymphadenopathy / Q000175:diagnosis*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D012680:Sensitivity and Specificity