A Case of Vagal Nerve Schwannoma in the Middle Mediastinum Diagnosed by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA)

Abstract

Background. Vagal nerve Schwannoma in the mediastinum is very rare and preoperative diagnosis is difficult. To our knowledge, this is the first case with vagal nerve Schwannoma diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Case. A 39-year-old man with Behcet's disease was consulted to our hospital because of an abnormal shadow on a chest X-ray. Enhanced computed tomography (CT) revealed 9 25×20mm right mediastinal tumor located dorsal to the right main bronchus. To diagnose this tumor, EBUS-TBNA was performed. Immunohistochemical staining showed S-100 positive spindle cell clusters in the specimens and diagnosed this tumor as vagal nerve Schwannoma. Therefore, resection of the tumor by video-assisted thoracic surgery was carried out. Indeed, the tumor covered the vagus nerve. Conclusion. This case indicated that EBUS-TBNA may be useful for diagnosis of the mediastinal tumor such as vagal nerve Schwannoma.