EBUS-TBNA in the workup of a mediastinal mass.

Abstract

Guided by endobronchial ultrasound (EBUS), mediastinal lymph nodes can be reached in a safe, minimally invasive manner, allowing fine needle aspiration for cytologic diagnosis with a high sensitivity and specificity. In describing the following clinical case, we demonstrate the use of EBUS-transbronchial needle aspiration (TBNA) in the workup of a paratracheal mass in a young female patient. Immunocytochemical analysis revealed it to be a peripheral nerve sheath tumor. EBUS-TBNA complemented computerized tomography, fluoro-deoxy-glucose positron emission tomography, and magnetic resonance imaging in establishing the diagnosis of this infrequently encountered mediastinal neoplasm. Fluoro-deoxy-glucose positron emission tomography has a potential to discriminate between high-grade sarcoma and benign soft tissue tumors, but it remains unreliable to differentiate benign schwannoma from low-grade sarcomas such as malignant peripheral nerve sheath tumor. When properly prepared, cell blocks obtained from TBNA of a paratracheal mass offer the possibility of cytologic examination and immunocytochemical staining, confirming the diagnosis of mediastinal neurogenic tumors.

• Authors: Jonas Yserbyt, Luc Van Zandweghe, Walter De Wever, Christophe Dooms
• Journal: Journal of bronchology & interventional pulmonology (J Bronchology Interv Pulmonol) Vol. 19 Issue 2 Pg. 162-4 (Apr 2012) ISSN: 1948-8270 [Electronic] United States
• PMID: 23207365 (Publication Type: Case Reports, Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Adult
• Endoscopic Ultrasound-Guided Fine Needle Aspiration (methods)
• Female
• Fluorodeoxyglucose F18
• Humans
• Magnetic Resonance Imaging
• Mediastinal Neoplasms (diagnosis, surgery)
• Nerve Sheath Neoplasms (diagnosis, surgery)
• Positron-Emission Tomography (methods)
• Radiopharmaceuticals