Metastatic carotid body paraganglioma of lungs and lymph nodes: Unsuspected diagnosis on EBUS-TBNA.

Paragangliomas are tumors that originate from the extra-adrenal chromaffin and nonchromaffin cells of neural crest origin. Lymph node metastases are common, while distant metastases to lung, liver, and bone are rare events and usually occur in the presence of a long standing clinically evident primary tumor. Primary diagnosis of paraganglioma at a metastatic site without a known primary is a diagnostic challenge. We report a case of an adult woman with incidentally detected metastasis to bilateral lungs from an occult carotid body paraganglioma, which presented a cytopathological diagnostic dilemma on EBUS-TBNA from paratracheal lymph nodes. Diagn. Cytopathol. 2017;45:327-332.