Recurrent hepatocellular carcinoma presenting as thoracic lymphadenopathy

Area of Science:

• Oncology
• Pulmonology
• Diagnostic Imaging

Background:

• Metastatic hepatocellular carcinoma (HCC) commonly affects the lung parenchyma.
• Thoracic lymphadenopathy as the predominant site of metastatic HCC is less frequently documented.
• Differentiating metastatic HCC from other malignant and non-malignant causes of lymphadenopathy is crucial for patient management.

Observation:

• Two cases of recurrent metastatic HCC presented with significant thoracic lymphadenopathy.
• The clinical presentation mimicked other neoplastic or inflammatory conditions.
• Accurate tissue diagnosis was essential for appropriate treatment and prognosis.

Findings:

• Linear endobronchial ultrasound (EBUS) with transbronchial needle aspiration (TBNA) was utilized for tissue acquisition.
• EBUS-TBNA provided adequate and safe tissue diagnosis in both cases.
• Histopathological analysis confirmed metastatic HCC in the enlarged thoracic lymph nodes.

Implications:

• This case series highlights EBUS-TBNA as a valuable tool for diagnosing metastatic HCC presenting as thoracic lymphadenopathy.
• It underscores the importance of considering metastatic HCC in patients with a history of liver cancer and unexplained mediastinal lymphadenopathy.
• Accurate and timely diagnosis facilitates appropriate oncological treatment and improves patient outcomes.