A 75-year-old man with a history of prostate cancer, treated with orchiectomy, androgen deprivation therapy, and radiation, was found to have multiple para-aortic lymph node swellings on MRI. Serum tumor markers related to prostate cancer were negative. Follow-up MRI demonstrated progression of the lymphadenopathy. PET-CT showed intense FDG uptake in the para-aortic and pelvic lymph nodes, without involvement of the prostate. Laboratory tests revealed elevated levels of carcinoembryonic antigen (CEA) and soluble interleukin-2 receptor (sIL-2R), leading to a referral for tissue diagnosis.
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed on the para-aortic lymph nodes using a GF-UCT260 echoendoscope. Histopathological examination of the specimen confirmed lung adenocarcinoma. Subsequent CT identified a 7 mm nodule in the right upper lobe, which was diagnosed as primary right upper lobe lung adenocarcinoma (cT1aN0M1c, Stage IVB).
To our knowledge, this is the first reported case of lung adenocarcinoma diagnosed via EUS-FNA of abdominal lymph nodes. This case highlights the utility of EUS-FNA in identifying extrapancreatic and extrapulmonary malignancies involving abdominal lymphadenopathy.
