Department of Respiratory Medicine, Kasukabe Medical Center, Kasukabe, Japan.
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Thorac Cancer. 2024 Jul;15(19):1533-1537. doi: 10.1111/1759-7714.15378. Epub 2024 May 25.
Schwannomas are classified as neurogenic tumors and are the most frequent nerve sheath tumors in the paravertebral mediastinum. Recently, the addition of endobronchial ultrasound-guided intranodal forceps biopsy (EBUS-IFB) using standard-sized biopsy forceps (SBFs) to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for metastatic lymph nodes in lung cancer patients reportedly improved the quality and quantity of the obtained specimens without significant complications. However, reports on the usefulness of this technique for benign diseases remain scarce. Here we report a case of schwannoma in the middle mediastinum, which was diagnosed by EBUS-IFB using SBFs, despite inadequate specimens obtained via EBUS-TBNA. An 80-year-old woman presented with dyspnea and a 5-cm sized middle mediastinal tumor. EBUS-TBNA and EBUS-IFB using SBFs were performed for histological diagnosis. No complications were associated with the bronchoscopy procedure, and schwannoma was solely diagnosed using the EBUS-IFB specimens. EBUS-IFB using SBFs is potentially useful for diagnosing benign diseases, including schwannomas, which are often difficult to diagnose with EBUS-TBNA.
神经鞘瘤被归类为神经源性肿瘤,是后纵隔最常见的神经鞘肿瘤。最近,在肺癌患者的经支气管超声引导下经支气管针吸活检(EBUS-TBNA)中加入标准活检钳(SBFs)的经支气管超声引导下腔内钳夹活检(EBUS-IFB),据称可以在不增加严重并发症的情况下提高获得标本的质量和数量。然而,关于该技术在良性疾病中的有用性的报道仍然很少。在此,我们报告了一例发生在中纵隔的神经鞘瘤病例,尽管通过 EBUS-TBNA 获得的标本不足,但通过 SBFs 的 EBUS-IFB 诊断为神经鞘瘤。一名 80 岁女性因呼吸困难和 5cm 大小的中纵隔肿瘤就诊。为了进行组织学诊断,进行了 EBUS-TBNA 和 SBFs 的 EBUS-IFB。支气管镜检查过程中无并发症,仅通过 EBUS-IFB 标本诊断为神经鞘瘤。使用 SBFs 的 EBUS-IFB 对于诊断良性疾病(包括神经鞘瘤)可能很有用,因为神经鞘瘤通常很难通过 EBUS-TBNA 诊断。