A 76-year-old man had productive cough, shortness of breath, and right pleural effusion for 6 months. He had previously received antibiotics for a right lower lobe infiltrate, and the pleural effusion was drained. A computed tomographic (CT) scan of the thorax revealed a nodular lesion in the right lower lobe and percutaneous needle aspiration (PCNA), performed 2 months ago by means of CT guidance, was nondiagnostic. His physical examination revealed nothing but a right pleural effusion, and his medical history was unremarkable, except for previous occupational exposure to asbestos. Chest X-ray and CT scan revealed diffuse irregular pleural thickening, moderate pleural effusion, and a nodular lesion in the lower lobe on the right. Flexible bronchoscopic examination showed an extrinsic compression of bronchus intermedius on the medial wall. Transbronchial needle aspiration (TBNA) of the lymph node located between the bronchus intermedius and left main bronchus; at the level of right middle lobe bronchus, was suspicious for malignancy. Transbronchial needle biopsy was repeated with a 19-gauge histology needle, and was diagnostic for malignant mesothelioma. To our knowledge, this is the first case of malignant mesothelioma diagnosed by TBNA biopsy in the literature.
- Malignant mesothelioma
- Transbronchial needle aspiration
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine