Spontaneous Regression Following Endobronchial Ultrasound-guided Transbronchial Needle Aspiration In Lung Cancer Patients
Sekine, A., Oda, T., Shintani, R., Ikeda, S., Baba, T., Iwasawa, T., Komatsu, S., Hagiwara, E., & Ogura, T. (2021). Spontaneous regression following endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer patients. Respiratory investigation, 59(5), 691–694. https://doi.org/10.1016/j.resinv.2021.05.003
View Original Source →Abstract
Spontaneous regression (SR) is defined as a complete or partial, temporary or permanent disappearance of a tumor without anticancer treatment, which potentially develops after surgery or biopsy for primary and metastatic tumors despite unknown incidence rate. Here, we report the incidence rate of SR after endobronchial ultrasound-guided transbronchial nodal needle aspiration (EBUS-TBNA) in lung cancer patients. Among 96 patients evaluable with chest CT before and after EBUS-TBNA, SR was found in three patients (3.1%). With regards to patient characteristics, two patients had small cell lung cancer (SCLC), and one patient had adenocarcinoma. All patients had stage 3 disease with a bulky N2 stage and a history of smoking. Two patients also had interstitial lung disease. Notably, SR was observed not only at the biopsied site, but also at the non-biopsied site. Our results indicate that SR can develop following EBUS-TBNA in a substantial proportion of lung cancer patients.
Case Details
Disease Location
Lung, lymph nodes
Personal Characteristics
81-year-old man. History of smoking
Clinical Characteristics
Consulted because of an abnormal chest radiography. Chest radiography showed a nodule in the right middle lobe, and chest CT demonstrated lymphadenopathy in multiple hilar and mediastinal lymph nodes, as well as a reticular shadow in both bases. Levels of progastrin-releasing peptide (progrp) and neuron-specific enolase (nse) were high. Endobronchial ultrasound-guided transbronchial nodal needle aspiration (ebus-tbna) from the #4r lymph node, and the diagnosis of small cell lung cancer (sclc) was made.
Remission Characteristics
Two months after ebus-tbna, chest radiography and CT showed shrinkage of the primary tumor and lymphadenopathy with a remarkable decrease in the levels of progrp and nse
Treatment & Mechanisms
Proposed Remission Mechanisms
Ebus-tbna causes a disruption of the metastatic lymph nodes, which potentially leads to the release of tumor antigens into systemic circulation and stimulate the immune system
Clinical Treatment
Biopsy