Intracellular and extracellular hyaline globules in endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal lymph node: A clue for the diagnosis of metastatic hepatocellular carcinoma

摘要

A 59-year-old male presented to our institution with progressive shortness of breath of a few weeks duration. Two years previously, he had undergone liver transplantation for end stage liver disease secondary to cirrhosis caused by hepatitis C and alcohol abuse, complicated by a 4.9 X 4.4 cm hepatocellular carcinoma. Imaging studies, performed as part of the evaluation for re-transplantation due to progressive worsening of his liver function, revealed bilateral pleural-based nodules and enlarged mediastinal lymph nodes ranging in size from 1.2 to 1.6 cm. The patient underwent endobronchial ultrasound-guided trans-bronchial needle aspiration of a mediastinal station 2L lymph node. Diff-Quik and Papanicolaou-stained smears and H&E-stained cellblock preparations were made.