Tang Jingyan, Guan Yuchen, Zhang Jianfeng, Guan Chengqi
Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong, China.
Front Oncol. 2025 Mar 25;15:1404211. doi: 10.3389/fonc.2025.1404211. eCollection 2025.
Mediastinal tumors present diagnostic challenges due to their unique location. This case report presents a patient diagnosed with primary mediastinal large B-cell lymphoma (PMBCL) using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), demonstrating the utility of this minimally invasive technique in detecting and confirming PMBCL.
A 34-year-old previously healthy woman came to our hospital complaining of dysphagia for 3 months. The gastroscopy showed a huge submucosal bulge in the middle of the esophagus, and a contrast-enhanced computed tomography scan of the chest revealed a left main bronchus nodule measuring 15 mm, mediastinal lymph node enlargement, and fusion with necrosis. Subsequently, we obtained the tissue from the mediastinal mass through EUS-FNA and the tissue from the left main bronchus nodule through transbronchoscope biopsy. According to the pathologic findings, we made a clear diagnosis: primary mediastinal large B-cell lymphoma.
As a minimally invasive technique, EUS-FNA is highly safe, repeatable, and accurate for lymphoma diagnosis. Although there are some limitations, it can play an important role in diagnosing mediastinal tumors.
纵隔肿瘤因其独特的位置而带来诊断挑战。本病例报告介绍了一名通过内镜超声引导下细针穿刺活检（EUS-FNA）诊断为原发性纵隔大B细胞淋巴瘤（PMBCL）的患者，展示了这种微创技术在检测和确诊PMBCL中的效用。
一名34岁既往健康的女性因吞咽困难3个月前来我院就诊。胃镜检查显示食管中段有巨大黏膜下隆起，胸部增强计算机断层扫描显示左主支气管有一个15毫米的结节、纵隔淋巴结肿大并伴有坏死融合。随后，我们通过EUS-FNA获取了纵隔肿块的组织，并通过经支气管镜活检获取了左主支气管结节的组织。根据病理结果，我们做出了明确诊断：原发性纵隔大B细胞淋巴瘤。
作为一种微创技术，EUS-FNA对淋巴瘤诊断具有高度安全性、可重复性和准确性。尽管存在一些局限性，但它在纵隔肿瘤诊断中可发挥重要作用。
