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Vol.63 No.3 contents | Japanese/English |
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- Case Report -
Two Lung Cancer Cases Safely and Rapidly Diagnosed with an Ultrasound-guided Cervical Lymph Node Biopsy Including Next-generation Sequencing at a Community-based Hospital
Daisuke Jingu1, Kosuke Sato1, Satoshi Ubukata1, Hiroshi Watanabe11Department of Respiratory Medicine, Saka General Hospital, Japan
Background. To diagnose patients with advanced lung cancer, it is important to safely collect sufficient samples necessary for current precision medicine, considering the general condition and underlying diseases of patients. Case 1. A 73-year-old man taking anticoagulants and antiplatelet drugs for chronic atrial fibrillation with a history of brain infarction associated with carotid artery stenosis was referred to our hospital. He had developed respiratory symptoms that suggested lung cancer two months ago, and abnormal shadows were detected on chest X-ray. Computed tomography demonstrated multiple mass lesions in the bilateral lung fields, and swelling of the right supraclavicular lymph node was also observed. An ultrasound-guided fine-needle aspiration biopsy was performed on the right supraclavicular lymph node. A morphological diagnosis along with a genetic diagnosis using next-generation sequencing (NGS) was performed, and adequate treatment was started. Case 2. A 68-year-old man taking dual antiplatelet drugs with a history of brain infarction visited our hospital. He had developed symptoms that suggested lung cancer one month ago. He had superior vena cava syndrome due to mediastinal lymphadenopathy, and right supraclavicular lymph node swelling was evident as well. Pericardial effusion and left internal jugular vein thrombosis were also observed. An ultrasound-guided fine-needle aspiration biopsy and semi-automatic needle biopsy were performed on the right supraclavicular lymph node. Lung adenocarcinoma was diagnosed histologically, but no driver mutations was observed by NGS. Conclusion. An ultrasound-guided cervical lymph node biopsy can provide sufficient samples for current precision medicine. This method can be a very useful tool and can be safely performed, particularly for patients who hesitate to undergo invasive procedures.
key words: Lung cancer, Ultrasound-guided, Needle biopsy, Lymph node metastasis, Fine-needle aspiration biopsy
Received: October 8, 2022
Accepted: March 10, 2023
JJLC 63 (3): 212-216, 2023
