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Case2 – NSCLC Stage III A (T2N2M0)

Authors: Prof. Felix JF Herth, MD, PhD, DSc, Thoraxklinik, University of Heidelberg, Germany Ralf Eberhardt, MD, PhD, Thoraxklinik, University of Heidelberg, Germany   Source: DVD-ROM ‘Endoscopic Ultrasound – Diagnostics and Staging of Lung Cancer’, Olympus Europa SE & Co. KG, 2013

Patient History

58 years, former smoker (25 cigarettes a day for 25 years) quit smoking 12 years ago.
Persistent cough, suspect of cancer, admitted for diagnosis/staging.
1
X-ray
Chest X-ray showed 45 mm large spiculate tumor in the right upper lobe [fig. 1].
CT
CT showed this tumor and an enlarged hilar (station 10R), subcarinal (station 7) [fig 2] and upper paratracheal lymph node (station 2R) [fig 3].

2

3
Endobronchial Ultrasound
EBUS-TBNA showed enlarged lymph nodes at station 2R [fig 4], 4R, 7 [fig 5], and 10R.

EBUS-TBNA case2-1
2:16

EBUS-TBNA case2-2
3:21

Cytology
NSCLC (squamous cell carcinoma) [fig. 6,7]

6

7
Diagnosis
NSCLC Stage III A (T2N2M0)
  Therapy
The patient was referred to chemotherapy.
  Benefit
Proper staging and treatment decision;
mediastinoscopy avoided.
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