Open AccessEBUS-TBNA in the Workup of a Mediastinal Mass
Author(s) -
Jonas Yserbyt,
Luc Van Zandweghe,
Walter De Wever,
Christophe Dooms
Publication year - 2012
Publication title -
journal of bronchology and interventional pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.648
H-Index - 33
eISSN - 1944-6586
pISSN - 1948-8270
DOI - 10.1097/lbr.0b013e318250341e
Subject(s) - medicine , schwannoma , radiology , positron emission tomography , magnetic resonance imaging , malignant peripheral nerve sheath tumor , nerve sheath neoplasm , sarcoma , mediastinum , pathology , neurofibromatosis
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.