A Case of Pleural Mesothelioma Diagnosed on Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Abstract

Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) exhibits a high diagnostic yield and is a less invasive procedure for evaluating mediastinal and hilar lymphadenopathies. In this report, we describe a case of pleural mesothelioma diagnosed based on the detection of metastases to the mediastinal lymph nodes on EBUS-TBNA. Case. An 81-year-old man noted a cough and shortness of breath on exertion for several years. An abnormal chest shadow was observed on a chest X-ray obtained during a medical check-up, and the patient was admitted to a prior hospital. However, he was not diagnosed using a closed pleural biopsy and was instead followed without therapy. He was subsequently referred to our hospital due to the exacerbation of right pleural effusion. We therefore performed EBUS-TBNA of the mediastinal lymph nodes (#4R) using immunohisto-chemistry and pathologically diagnosed the patient with mediastinal lymph node metastasis of pleural mesothelioma. Conclusions. EBUS-TBNA of metastases to the mediastinal lymph nodes is an effective means of detecting pleural mesothelioma.