EBUS-TBNA in the Workup of a Mediastinal Mass

Yserbyt, Jonas MD*; Van Zandweghe, Luc MD; De Wever, Walter PhD; Dooms, Christophe PhD*

Journal of Bronchology & Interventional Pulmonology:
doi: 10.1097/LBR.0b013e318250341e
Brief Reports
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.

Author Information

*Department of Pneumology, Katholieke Universiteit Leuven

Department of Radiology, Universitair Ziekenhuis Gasthuisberg, Leuven

Department of Pneumology, Algemeen Ziekenhuis Sint Blasius, Dendermonde, Belgium

Disclosure: There is no conflict of interest or other disclosures.

Reprints: Jonas Yserbyt, MD, Department of Pneumology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium (e-mail: jonas.yserbyt@uzleuven.be).

Received February 5, 2012

Accepted February 14, 2012

© 2012 Lippincott Williams & Wilkins, Inc.