Successful diagnosis of a combined thymic epithelial tumor by endobronchial ultrasound-guided transbronchial needle aspiration.

Endobronchial ultrasound-guided tranbronchial needle aspiration (EBUS-TBNA) can be applied to not only the determination of the clinical stages of lung cancer, but also the diagnosis of lymphadenopathies such as lymphoma and sarcoidosis.CASE REPORTWe report the successful diagnosis of a combined thymic epithelial tumor in a 68-year-old female by EBUS-TBNA. The patient presented with a 6-month history of dysesthesia in bilateral legs. Chest computed tomography revealed a 5.5 cm-tumor with heterogeneous enhancement in the superior and anterior mediastinum. The serum levels of ProGRP and NSE were elevated and anti-Hu antibody was positive at the time of diagnosis. A biopsy by EBUS-TBNA revealed histological evidence of a combined thymic epithelial tumor consisting of small cell neuroendocrine carcinoma and thymic carcinoma. Chemo-radiotherapy reduced the tumor remarkably in size, but the patient's neurologic symptoms remained.CONCLUSIONThis case suggests that EBUS-TBNA is a safe and useful technique for the diagnosis of paratracheal mediastinal tumors.