Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Evaluation of Suspected Lymphoma Daniel P. Steinfort, MBBS, FRACP, Matthew Conron,

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Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Evaluation of Suspected Lymphoma Daniel P. Steinfort, MBBS, FRACP, Matthew Conron, MBBS, FRACP, Alpha Tsui, MBBS, FRCPA, Sant-Rayn Pasricha, MBBS, William E.P. Renwick, MBBS, FRACP, Phillip Antippa, MBBS, FRACS, Louis B. Irving, MBBS, FRACP Journal of Thoracic Oncology Volume 5, Issue 6, Pages 804-809 (June 2010) DOI: 10.1097/JTO.0b013e3181d873be Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 A, EBUS-TBNA specimen demonstrating a uniform population of small lymphocytes. Immunohistochemical staining was positive for CD 20 (pictured), CD 5, and CD23 confirming small lymphocytic lymphoma. B, EBUS-TBNA specimen demonstrating malignant cells in a background of lymphoid cells. Immunohistochemistry showed positive staining with CD 30 (pictured) and negative staining for epithelial markers. EBUS-TBNA specimens suggested anaplastic large cell lymphoma. Surgical biopsy confirmed the presence of anaplastic large cell lymphoma. EBUS-TBNA, endobronchial ultrasound-guided transbronchial needle aspiration. Journal of Thoracic Oncology 2010 5, 804-809DOI: (10.1097/JTO.0b013e3181d873be) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Flow diagram illustrating the method by which diagnosis was achieved in all patients ultimately diagnosed with lymphoma. Final diagnoses are grouped according to the utility of EBUS-TBNA for each patient. EBUS-TBNA, endobronchial ultrasound-guided transbronchial needle aspiration; IMLN, isolated mediastinal lymphadenopathy; HL, Hodgkin lymphoma; LN, lymph node. Journal of Thoracic Oncology 2010 5, 804-809DOI: (10.1097/JTO.0b013e3181d873be) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 A, Axial contrast-enhanced computed tomography chest image from patient with clinical superior vena cava (SVC) obstruction demonstrating prominent right paratracheal lymphadenopathy causing significant narrowing of the SVC. Large collateral vessels in the right paratracheal region may be seen posterior to the narrowed SVC (arrow). B, Endobronchial ultrasound image of right paratracheal region of patient in (A). Doppler mode demonstrates large vessels within a poorly defined lymph node mass (arrowheads). Journal of Thoracic Oncology 2010 5, 804-809DOI: (10.1097/JTO.0b013e3181d873be) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions