title: Mediastinal mass diagnosed by endobronchial ultrasound as recurrent hepatocellular carcinoma in a post-liver transplantation patient.
abstract: OBJECTIVE
  We presented a rare case of recurrent hepatocellular carcinoma after liver transplant manifested as an isolated mediastinal mass.
  
  
  METHODS
  A 62-year-old man was referred for evaluation of atypical chest pain and abnormal finding of a computed tomography of the chest. He had history of chronic hepatitis C liver cirrhosis and hepatocellular carcinoma underwent orthotopic liver transplant as a curative treatment three years earlier.
  
  
  RESULTS
  The computed tomography of the chest demonstrated paratracheal mediastinal lymphadenopathy. He subsequently underwent endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA). The right paratracheal lymph node station 4R was sampled. Rapid on-site cytology evaluation demonstrated recurrent metastatic hepatocellular carcinoma.
  
  
  CONCLUSIONS
  Pulmonologist should be cognizant of diagnostic utility of EBUS-TBNA in this clinical setting as more transplant patients on immunosuppressive medications with enlarged mediastinal lymphadenopathy of unknown origin will be referred for further evaluation.
authors.affiliation: Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: Abdul Hamid
authors.initials: AH
authors.lastname: Alraiyes
authors.affiliation: School of Medicine and Biomedical Sciences, University at Buffalo-State University of New York (SUNY), Buffalo, NY, USA.
authors.forename: Pichapong
authors.initials: P
authors.lastname: Tunsupon
authors.affiliation: Health Sciences Center, Tulane University, New Orleans, LA, USA.
authors.forename: Fayez
authors.initials: F
authors.lastname: Kheir
authors.affiliation: Temple University, Philadelphia, PA, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Salerno
keywords: Endobronchial ultrasound; liver transplantation; recurrent hepatocellular carcinoma