Prostate Cancer with Mediastinal Lymph Node Metastasis Diagnosed by Transbronchial Needle Aspiration: A Case Report

經支氣管細針抽吸診斷攝護腺癌併縱膈腔淋巴腺轉移：病例報告

鐘桂彬(Kuei-Pin Chung) ； 何肇基(Chao-Chi Ho) ； 余忠仁(Chong-Jen Yu)

《胸腔醫學》 25卷5期 (2010/10) Pp. 279-285

https://doi.org/10.29806/TM.201010.0009

摘要

攝護腺癌可以造成骨轉移或是局部淋巴腺轉移。縱膈腔淋巴腺轉移於攝護腺癌較為罕見，其可以在初診斷時或是治療後發生。在經支氣管鏡超音波尚未發展的年代，縱膈腔淋巴腺轉移需要倚賴侵襲性的術式，例如：縱膈腔鏡、胸腔鏡、或是開胸手術。經支氣管鏡超音波併細針抽吸的應用可以提供縱膈腔淋巴腺腫大良好的診斷資訊。我們在此報告一個67歲的男性攝護腺癌病人，於治療中發生縱膈腔淋巴腺轉移以及肺部癌性淋巴管炎，並由經支氣管鏡超音波併細針抽吸的使用確立診斷。對於攝護腺癌併縱膈腔淋巴腺腫大，攝護腺癌轉移需要納入鑑斷的考慮。其診斷可以利用經支氣管鏡超音波併細針抽吸加以確認，而避免侵襲性較高的診斷術式。

關鍵字

攝護腺癌 ； 縱膈腔淋巴腺腫大 ； 經支氣管鏡超音波 ； 經支氣管細針抽吸

並列摘要

Prostate cancer metastases usually involve the skeletal system or regional lymph nodes. Mediastinal lymph node metastases are rare in prostate cancer, and may develop at presentation or during treatment. Before the introduction of endobronchial ultrasonography, invasive procedures such as mediastinoscopy or thoracoscopy were required for the definite diagnosis. With the application of convex probe endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA), the etiology of mediastinal lymphadenopathy can be confirmed and more invasive methods avoided. We described a 67-year-old man with prostate cancer who subsequently developed mediastinal lymph node metastases and pulmonary lymphangitis carcinomatosis during the treatment course. The diagnosis of mediastinal lymph node metastases was confirmed by EBUS-TBNA. We concluded that mediastinal lymph node metastases could develop in prostate cancer and could be confirmed by EBUS-TBNA.

並列關鍵字

prostate cancer ； mediastinal lymphadenopathy ； endobronchial ultrasonography ； transbronchial needle aspiration