Mediastinal Solitary Fibrous Tumor Diagnosed by Endobronchial Ultrasound-Directed Biopsy.
Mediastinal Solitary Fibrous Tumor Diagnosed by Endobronchial Ultrasound-Directed Biopsy.
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DOI：
10.12659/ajcr.903680
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发表时间：
2017-05-18
期刊：
影响因子：
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通讯作者：
Utz JP
中科院分区：
文献类型：
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作者：
Webb AJ;Yassin AS;Saeed A;Yadav H;Utz JP
患者：男性，32 岁 最终诊断：纵隔孤立性纤维瘤 症状：咳嗽 • 呼吸困难 • 进行性吞咽困难 • 间歇性胸痛恶化 药物治疗： — 临床手术：软式支气管镜检查 • 支气管内超声 (EBUS) 专业：肺科 罕见疾病 中纵隔间隙孤立性纤维瘤并不常见，通常直到出现继发于邻近结构受压的症状后才被发现。诊断需要手术活检和组织学组织分析。我们描述了孤立性纤维瘤的 ECHO 表现和成功的非侵入性 EBUS 诊断。这种诊断方法允许制定切除手术计划，并允许我们排除非手术疾病，例如小细胞癌。一名 32 岁男性因间歇性慢性胸痛恶化并伴有近期进行性吞咽困难、咳嗽和呼吸困难而向其初级保健医生就诊。体格检查和常规实验室检查没有发现任何问题。胸部X光片和胸部计算机断层扫描（CT）显示中纵隔肿块。柔性支气管镜检查证实左右支气管树受到外在压迫。采用支气管内超声（EBUS）对肿块进行活检，确诊为孤立性纤维瘤。患者成功进行了肿瘤切除术，术后平稳出院回家。支气管内超声引导的组织活检是疑似纵隔孤立性纤维瘤的合适方法。据我们所知，这只是 EBUSTBNA 诊断的第二例 SFT 病例。我们的案例独特地证明了当 CT 和 US 成像建议诊断 SFT 时，使用 EBUS-TBNA 对纵隔肿块进行术前诊断的优势。
Patient: Male, 32 Final Diagnosis: Mediastinal solitary fibrous tumor Symptoms: Cough • dyspnea • progressive dysphagia • worsening intermittent chest pain Medication: — Clinical Procedure: Flexible bronchoscopy • endobronchial ultrasound (EBUS) Specialty: Pulmonology Rare disease Solitary fibrous tumors of the middle mediastinal space are uncommon and often not discovered until symptoms secondary to compression of adjacent structures occur. Diagnosis requires surgical biopsy and histological tissue analysis. We describe the ECHO appearance of the solitary fibrous tumor and successful non-invasive EBUS diagnosis. This method of diagnosis allowed for surgical planning for resection and allowed us to exclude non-surgical diseases, such as small cell carcinoma. A 32-year-old man presented to his primary care physician with worsening intermittent chronic chest pain with recent progressive dysphagia, cough, and dyspnea. Physical examination and routine laboratory work-up were unrevealing. Chest radiograph and computed tomography (CT) of the chest revealed a middle mediastinal mass. Flexible bronchoscopy confirmed extrinsic compression of right and left bronchial trees. Endobronchial ultrasound (EBUS) was used to biopsy the mass and the diagnosis of solitary fibrous tumor was confirmed. The patient underwent successful tumor resection and was discharged home after an uneventful postoperative period. Endobronchial ultrasound-directed tissue biopsy is an appropriate modality for suspected solitary fibrous tumors of the mediastinum. To our knowledge, this is only the second reported case of SFT diagnosed by EBUSTBNA. Our case uniquely demonstrates the advantages of pre-surgical diagnosis of mediastinal masses with EBUS-TBNA when the diagnosis SFT is suggested on CT and US imaging.