Abstract
Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can be performed as a minimally invasive procedure to diagnose mediastinal lesions. Case. A 48-year-old man with a history of chemotherapy for malignant lymphoma underwent follow-up chest computed tomography (CT), which showed a round, well-circumscribed 29×23mm mass in the right superior mediastinum. ^<18>F-fluorodeoxyglucose positron emission tomography/CT (^<18>F-FDG-PET/CT) demonstrated mild radiotracer uptake in the mass lesion with maximum standardized uptake value (SUVmax) of 2.8. To differentiate recurrence of malignant lymphoma from other mediastinal tumors, EBUS-TBNA was performed. The histological diagnosis was mediastinal schwannoma, which seemed to have originated from the intrathoracic vagus nerve. Surgical resection was avoided in order to prevent recurrent nerve paralysis as a complication of surgery. The tumor has not increased in size during a 2.5-year period. Conclusion. Almost all reported cases of mediastinal schwannomas were diagnosed by surgical resection. In the present case, we could diagnose the mediastinal schwannoma by minimally invasive EBUS-TBNA and avoid potential complications of surgery. EBUS-TBNA can be applied to patients as a preoperative diagnostic procedure for all accessible mediastinal lesions contiguous with the trachea or bronchi.
