EBUS was performed to approach the station 7 lymph node:
Macroscopy: Endobronchial ultrasound-guided TBNA of lymph node station 7R - 5 passes: 8 air-dried smears, 7 alcohol-fixed smears & cell block prepared. Cytologist in attendance.
Microscopy: The smears show a population of atypical epithelioid cells with enlarged, pleomorphic nuclei, irregular nuclear membranes, small nucleoli and delicate, vacuolated cytoplasm arranged in scattered small groups. Rare clusters of atypical cells are identified within the cell block, together with fragments of the reactive stroma. Chronic inflammatory cells, anthracosis histiocytes and abundant blood are present within the background.
Conclusion: EBUS-TBNA Station 7 lymph node: Malignant - Features consistent with non-small cell carcinoma and favouring adenocarcinoma.
A limited immunopanel has been requested on the cell block, within which malignant cells are present in only small numbers. A supplementary report will follow. There is insufficient material for molecular testing.mmunohistochemistry has been performed on the cell block. The atypical cell population shows immunoreactivity with antibodies against TTF1 and is negative with antibodies against p40. The immune profile is consistent with adenocarcinoma of primary pulmonary origin.