PMC6008285_01
A. Chest CT (soft tissue window) at level of T9. Note the vicinity of the pleural mass (marked with arrow) to the esophagus (marked as *); B. PET-CT taken month later. Note the high FDG uptake (marked as *).; C. US imaging of mediastinal pleural mass adjacent to the lower segment of the esophagus was identified with EBUS scope (marked as *).
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Chest computed tomography (CT) revealed multiple bilateral pleural masses and mediastinal lymphadenopathy (Fig. 1A1B).
US imaging of mediastinal pleural mass adjacent to the lower segment of the esophagus was identified with EBUS scope (marked as *).
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EBUS guidance, a pleural mass adjacent to the lower segment of the esophagus was identified (Fig. 2). EUS-B-FNA was performed of the pleural mass using a 21-gauge needle.
Pathology results: A. EBUS, lymph node, station 4R: Fragments of carcinoma with a background of benign respiratory epithelium, cartilage and lymphoid tissue (Hematoxyllin & Eosin, magnification x40); B. Pleural mass, EUS: Fragments of carcinoma with morphological features suggesting clear cell carcinoma (H&E, x400); C. The immunostain results and histological features favor the diagnosis of metastatic clear cell renal cell carcinoma: C1. Immuohistochemical stain, PAX-8, x40. positive; C2. Immuohistochemical stain, CA-IX, x40. membranous positive staining.
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The specimens were examined cytologically, histologically and immunohistochemically (Fig. 3).