부산대학교 도서관

The role of gastrointestinal endoscopic ultrasonography-guided fi ne needle aspiration (EUS-FNA) is well established for staging mediastinal lymph nodes in patients with lung cancer. EUS-FNA can also potentially target primary lung masses abutting or adjacent to the esophagus. Here, we report a case of lung cancer diagnosed pathologically using EUS-FNA of a primary lung mass per se. An 82-year-old woman with a history of hypertension was admitted because of dyspnea. Physical examination revealed coarse breath sounds with crackles and wheezing over both lower lobes of the lungs. Chest computed tomography (CT) revealed consolidation of both lower lobes and about a 3 cm sized mass-like lesion located between the esophagus and the aorta, in the left lower lobe. Transthoracic needle aspiration was not attempted because of the risk of pneumothorax and of puncturing the aorta. EUS-FNA of lung mass was performed and cytological examination revealed malignant cells consistent with adenocarcinoma. After 2 cycles of palliative chemotherapy with gemcitabine, the patient has received supportive care for the past 4 months. EUS-FNA appears to be a safe and feasible diagnostic method for lung masses when the lesions are located adjacent to the esophagus and where conventional diagnostic modalities are not feasible because of the risks.