Open Access Case report

False positive endobronchial ultrasound-guided real-time transbronchial needle aspiration secondary to bronchial carcinoma in situ at the point of puncture: a case report

José Sanz-Santos1,2*, Felipe Andreo1,3, Pere Serra1, María Llatjós4, Eva Castellà4, Julio Astudillo5, Eduard Monsó2,3,6 and Juan Ruiz-Manzano1,2

Author Affiliations

1 Pulmonology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet S/N, 08916, Badalona, Barcelona, Spain

2 Medicine Department, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain

3 Ciber de Enfermedades Respiratorias (CiBERES), Bunyola, Balearic Islands, Spain

4 Pathology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet S/N, 08916, Badalona, Barcelona, Spain

5 Thoracic Surgery Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet S/N, 08916, Badalona, Barcelona, Spain

6 Pulmonology Department, Hospital Parc Taulí, Sabadell, Barcelona, Spain

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Journal of Cardiothoracic Surgery 2012, 7:74 doi:10.1186/1749-8090-7-74

Published: 14 August 2012

Abstract

Since the development of endobronchial ultrasound-guided real-time needle aspiration (EBUS-rt-TBNA) no false positive (FP) cases have been described. We present the first FP case for EBUS-rt-TBNA secondary to a carcinoma in situ (CIS) in the bronchial point of puncture. A 66-years-old male was referred to our Institution because of a mass in left lower lobe. The bronchoscopy did not show any endobronchial lesion. The cytology of the washing confirmed an unspecified non-small cell lung cancer. An EBUS-rt-TBNA for staging was carried out. No mediastinal nodes over 5 mm length were found but one single left hilar node at station 11 L was sampled. The cytology of the TBNA showed lymphocytes and neoplastic squamous cells. The patient underwent thoracotomy. On the surgical specimen no metastasis on any of the nodes resected were detected but a CIS on the bronchial resection margin was described. A bronchial biopsy confirmed CIS on the bronchial stump. The reported case depicts an unusual situation, we consider EBUS-rt-TBNA an accurate technique if minimal requirements are met

Keywords:
Lung Cancer; Endobronchial Ultrasound; Staging; False Positive; Carcinoma in situ