title: 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.affiliation: Department of Pneumology, Katholieke Universiteit Leuven, Belgium. jonas.yserbyt@uzleuven.be
authors.forename: Jonas
authors.initials: J
authors.lastname: Yserbyt
authors.forename: Luc
authors.initials: L
authors.lastname: Van Zandweghe
authors.forename: Walter
authors.initials: W
authors.lastname: De Wever
authors.forename: Christophe
authors.initials: C
authors.lastname: Dooms
mesh_terms: D000328:Adult; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D018317:Nerve Sheath Neoplasms / Q000175:diagnosis* / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18