Endoscopic ultrasonography-guided fine-needle cytodiagnosis of mediastinalmetastases from renal cell cancer

Background: Endoscopic ultrasonography (EUS) has become the investigation o f choice for the evaluation of the mediastinum, Lung and mediastinum are am ongst the common sites of metastases from renal cell cancer (RCC), We diagn osed metastatic RCC in mediastinal lymph nodes by EUS-guided fine-needle as piration (FNA) cytology, Methods: A total of 111 patients with mediastinal lymph nodes had undergone EUS-FNA using a linear array echo endoscope and a 170 cm, 22 G GIP needle consecutively, Smears were prepared, air-dried, and sent to an independent cytologist, Results: Seven patients tall males, mean age 64.8 years, range 45-72) were diagnosed cytologically to have metastatic RCC, Three patients had been dia gnosed with RCC in the past (2,7, and 17 years ago) while in the others, th is was primarily diagnosed on the basis of EUS-FNA, The EUS features of the se mediastinal RCC metastases include irregular lesions with inhomogenous e chotexture, measuring 2.8 cm (median; range 1.0-4.5) located predominantly in the posterior mediastinum, Conclusion: EUS-FNA diagnosis of metastatic RCC is safe and feasible. It is especially useful in the evaluation of the mediastinum for suspected metas tase, Cytology examination results in combination with clinical features co uld suggest the site of origin of the primary, assisting in further managem ent.