Northwestern Medicine, Department of Internal Medicine, McHenry, IL, USA.
Northwestern Medicine, Pulmonary and Critical Care Medicine, McHenry, IL, USA.
J Investig Med High Impact Case Rep. 2024 Jan-Dec;12:23247096241235534. doi: 10.1177/23247096241235534.
Mediastinal masses present a diagnostic challenge due to their similar imaging characteristics, making distinguishing between noninfectious and infectious processes or malignancies difficult. A mediastinal abscess can result in severe life-threatening infections if left untreated. Traditional treatment approaches involve surgical debridement and drainage; however, emerging endobronchial techniques, such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), offer a less-invasive means of diagnosing and managing abscesses. Herein, we describe a case of a young male patient who exhibited nonspecific symptoms, including pleuritic chest pain, shortness of breath, and fever. Imaging revealed a mediastinal mass with granuloma formation. EBUS-TBNA successfully drained the abscess, and microbiology analysis confirmed the growth of . Subsequently, his symptoms resolved, and follow-up imaging demonstrated the resolution of the mass and associated calcifications. Further research is warranted to assess the role of EBUS-TBNA in benign mediastinal masses with granuloma formation.
纵隔肿块因其影像学特征相似而具有诊断挑战性,使得区分非传染性和传染性过程或恶性肿瘤变得困难。纵隔脓肿如果不治疗,可能会导致严重的危及生命的感染。传统的治疗方法包括手术清创和引流;然而,新兴的支气管内技术,如支气管内超声引导经支气管针吸活检术(EBUS-TBNA),提供了一种诊断和治疗脓肿的微创方法。在此,我们描述了一例年轻男性患者,其表现出非特异性症状,包括胸膜炎性胸痛、呼吸急促和发热。影像学显示纵隔肿块伴肉芽肿形成。EBUS-TBNA 成功引流脓肿,微生物学分析证实生长。随后,他的症状得到缓解,随访影像学显示肿块和相关钙化的消退。需要进一步的研究来评估 EBUS-TBNA 在伴有肉芽肿形成的良性纵隔肿块中的作用。