The utility of endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-TBMC) for the diagnosis of mediastinal lymphoma

• Main Authors: Nai-Chien Huan, Wei Lun Lee, Hema Yamini Ramarmuty, Larry Ellee Nyanti, Melody Shu Ling Tsen, Dahziela Yunus
• Format: Article
• Language: English; English
• Published: Wiley-Blackwell Publishing Ltd 2024
• Subjects: RC254-282 Neoplasms. Tumors. Oncology Including cancer and carcinogens; RC31-1245 Internal medicine
• Online Access: https://eprints.ums.edu.my/id/eprint/41861/1/ABSTRACT.pdf; https://eprints.ums.edu.my/id/eprint/41861/2/FULL%20TEXT.pdf; https://eprints.ums.edu.my/id/eprint/41861/; https://doi.org/10.1002/rcr2.1342

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a revolutionary tool for the diagnosis and staging of mediastinal disorders. Nevertheless, its diagnostic capability is reduced in certain disorders such as lymphoproliferative diseases. EBUS-guided transbronchial mediastinal cryobiopsy (EBUS-TBMC) is a novel technique that can provide larger samples with preserved tissue architecture, with an acceptable safety profile. In this case report, we present a middle-aged gentleman with a huge anterior mediastinal mass and bilateral mediastinal and hilar lymphadenopathy. He underwent EBUS-TBNA with rapid on-site evaluation (ROSE) followed by EBUS-TBMC, all under general anaesthesia. Histopathological analysis showed discordance between EBUS-TBNA and EBUS-TBMC in which only TBMC samples provided adequate tissue to attain a diagnosis of primary mediastinal large B-cell lymphoma. This case report reinforced the diagnostic role of EBUS-TBMC in the diagnosis of lymphoproliferative diseases.