title: Successful diagnosis of a combined thymic epithelial tumor by endobronchial ultrasound-guided transbronchial needle aspiration.
abstract: BACKGROUND
  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.
  
  
  METHODS
  We 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.
  
  
  CONCLUSIONS
  This case suggests that EBUS-TBNA is a safe and useful technique for the diagnosis of paratracheal mediastinal tumors.
authors.affiliation: Department of Integrated Pulmonology, Tokyo Medical and Dental University.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Okamoto
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sakakibara
authors.forename: Meiyo
authors.initials: M
authors.lastname: Tamaoka
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sumi
authors.forename: Naohiko
authors.initials: N
authors.lastname: Inase
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001980:Bronchi; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis*; D003937:Diagnosis, Differential; D051959:ELAV Proteins / Q000097:blood; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D005768:Gastrointestinal Hormones / Q000097:blood; D006801:Humans; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis*; D010446:Peptide Fragments / Q000097:blood; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011994:Recombinant Proteins / Q000097:blood; D013945:Thymoma / Q000175:diagnosis*; D013953:Thymus Neoplasms / Q000175:diagnosis; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D014408:Biomarkers, Tumor; D051959:ELAV Proteins; D005768:Gastrointestinal Hormones; D010446:Peptide Fragments; D011994:Recombinant Proteins; C087079:pro-gastrin-releasing peptide (31-98); D010751:Phosphopyruvate Hydratase