Lung cancer diagnosed by transesophageal endoscopic ultrasound.

Abstract

Lung cancer remains one of the leading causes of morbidity and mortality worldwide. Although bronchoscopy and percutaneous approaches are commonly used for diagnosis, certain pulmonary lesions with challenging locations may limit their accessibility. We present the case of a 56-year-old male, an active smoker with moderate chronic obstructive pulmonary disease, in whom follow-up computed tomography revealed significant growth of a paramediastinal pulmonary nodule in the right lower lobe. Positron emission tomography showed marked hypermetabolic activity consistent with primary lung malignancy. Due to the lesion’s location and the difficulty of conventional access, transesophageal endoscopic ultrasound was performed, identifying a solid pulmonary mass with pleural and vascular involvement. Fine-needle aspiration confirmed the diagnosis of non–small cell lung carcinoma, adenocarcinoma subtype, with negative PD-L1 and ALK status. This case highlights the value of transesophageal endoscopic ultrasound as a safe and effective diagnostic tool for pulmonary lesions in anatomically challenging locations, enabling histological confirmation and supporting optimal therapeutic planning.

Keywords: lung cancer, endoscopic ultrasound.