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Case Reports
. 2024 Jan-Dec:12:23247096241235534.
doi: 10.1177/23247096241235534.

Using Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Diagnosis and Treatment of a Mediastinal Mass With Eccentric Calcifications: A Case Report

Ruba Ghalayni  1 , Satish Gowda  2
Affiliations
Case Reports

Using Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Diagnosis and Treatment of a Mediastinal Mass With Eccentric Calcifications: A Case Report

Ruba Ghalayni et al. J Investig Med High Impact Case Rep. 2024 Jan-Dec.

Abstract

Mediastinal masses present a diagnostic challenge due to their similar imaging characteristics, making distinguishing between noninfectious and infectious processes or malignancies difficult. A mediastinal abscess can result in severe life-threatening infections if left untreated. Traditional treatment approaches involve surgical debridement and drainage; however, emerging endobronchial techniques, such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), offer a less-invasive means of diagnosing and managing abscesses. Herein, we describe a case of a young male patient who exhibited nonspecific symptoms, including pleuritic chest pain, shortness of breath, and fever. Imaging revealed a mediastinal mass with granuloma formation. EBUS-TBNA successfully drained the abscess, and microbiology analysis confirmed the growth of Streptococcus intermedius. Subsequently, his symptoms resolved, and follow-up imaging demonstrated the resolution of the mass and associated calcifications. Further research is warranted to assess the role of EBUS-TBNA in benign mediastinal masses with granuloma formation.

Keywords: Endobronchial ultrasonography; Granuloma; Mediastinal abscess; Mediastinal mass; Transbronchial needle aspiration.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Mediastinal mass (7.4 cm) with eccentric calcifications resulting in a mass effect on the right pulmonary artery.
Figure 2.
Figure 2.
Subcarinal lymphadenopathy with purulence as seen on bronchoscopy.
Figure 3.
Figure 3.
Avid FDG uptake in subcarinal lymph node indicating infection.
Figure 4.
Figure 4.
Almost complete resolution of the mediastinal mass and associated calcifications.
See this image and copyright information in PMC

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