Black bronchoscopy in a patient with pulmonary malignant melanoma: A case report

A 47-year-old Japanese man was referred to our hospital with a one-week history of chest discomfort. Chest computed tomography (CT) revealed a mass in the right upper lobe suspected to be primary lung cancer. A biopsy of the mass using endobronchial ultrasonography (EBUS) with guide sheath (GS) was performed, and a black-colored mass was observed which occluded almost all of the right B² b bronchus. Immunohistochemistry of lung specimens was compatible with a diagnosis of malignant melanoma which was confirmed to be BRAF wild-type. Furthermore, positron emission tomography (PET) and contrast-enhanced magnetic resonance imaging (MRI) of the head revealed multiple metastatic lesions in the brain, liver, and bones. The patient was referred to another hospital for specific treatment. After that, the patient's melanoma was confirmed to have the BRAF wild-type gene and PD-L1 expression was 80%. Then, combined therapy of nivolumab plus ipilimumab was subsequently administered.