We present a case of mediastinal diffuse large B-cell lymphoma (DLBCL) diagnosed using EUS-FNA. An 85-year-old man with a history of surgery for hepatocellular carcinoma (HCC) and chemotherapy for prostate carcinoma underwent regular follow-up for HCC using contrast CT. CT revealed a contrasted mass with an irregular marginal outline and a clear border, located mainly in the superior mediastinum. The lesion had increased from 1.7-cm to 5-cm. PET-CT showed high standardized uptake value, suggesting a malignant tumor. EUS-FNA using a 19-gauge needle was performed to obtain the pathological evidence. EUS could not visualize the lesion clearly in the left-lateral position. However, after turning the position from lateral to prone, EUS visualized the lesion closely and clearly. The pathological diagnosis of DLBCL was made.
Postural change may be a simple alternative technique for mediastinal lesions where transesophageal puncture is difficult.
