Endobronchial ultrasound-guided transbronchial needle aspiration as a diagnostic modality for schwannoma: A case report

Liu, Wei; Li, Yun; Chen, Lingjia; Liu, Zhiguang; Zhang, Weidong

doi:10.1097/md.0000000000029669

Cited by 4 publications

(5 citation statements)

References 25 publications

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“…Mediastinal cysts are congenital, benign conditions that account for approximately 12–30% of all mediastinal lesions ( 6 ). If the volume of a cyst expands, it can exert pressure on adjacent organs, thereby affecting the cardiac and pulmonary function of the fetus.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the prenatal ultrasound diagnostic value and prognostic factors of fetal mediastinal cysts

Ma,

Pan,

et al. 2024

Quant Imaging Med Surg

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Background A prenatal fetal mediastinal cyst is a benign disease. However, if a cyst enlargement grows, it may compress the adjacent organs and affect the fetal cardiopulmonary function. This study aimed to compare and analyze the prenatal ultrasound characteristics of different mediastinal cysts, and to evaluate the pregnancy outcome of the fetus and the factors affecting the prognostic of the fetus. To compare and analyze the prenatal ultrasound characteristics of different types of mediastinal cysts, and to evaluate the fetal pregnancy outcome and the influencing factors of fetal prognosis. Methods A retrospective analysis of patients with prenatal diagnoses of mediastinal cysts was conducted to evaluate the ultrasound characteristics and to monitor the pregnancy outcomes to identify prognostic influences and provide a reliable basis for patient prognosis. Results In total, 30 patients were diagnosed with mediastinal cysts [including bronchogenic cysts (n=12), esophageal cysts (n=9), pericardial cysts (n=5), and thymic cysts (n=4)] on prenatal ultrasonography. The diagnostic accuracy rate was 93.33%; two cases of esophageal cysts were misdiagnosed as bronchial cysts. In total, 4 (44.44%) of 9 esophageal cysts and 4 thymic cysts were located in the anterior mediastinum, 10 (83.33%) of 12 bronchogenic cysts and 5 pericardial cysts were located in the middle mediastinum, and 2 (16.67%) of 12 bronchogenic cysts and 5 (55.56%) of 9 esophageal cysts were located in the posterior mediastinum. There were significant differences in the distribution of the cyst location, morphology, and cyst wall thickness (P<0.05). After delivery, 17 patients had clinical symptoms. There was a significant difference in the clinical symptoms between patients with a maximum diameter of postpartum cysts <5 and ≥5 cm (P<0.05), and children with a low gestational age and birth weight were more likely to have clinical symptoms. Conclusions The prenatal ultrasound features of fetal mediastinal cysts were similar. However, the ultrasound characteristics related to the cyst location, morphology, and cyst wall thickness were helpful in providing an accurate diagnosis. In addition, the postpartum cyst size, location, adjacent relationship with the surrounding tissues, volume, gestational age, and weight were related to patient prognosis.

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Section: Discussionmentioning

confidence: 99%

Analysis of the prenatal ultrasound diagnostic value and prognostic factors of fetal mediastinal cysts

Ma,

Pan,

et al. 2024

Quant Imaging Med Surg

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“…Here we present a case of schwannoma diagnosed with EBUS‐IFB using SBFs. Diagnosis of neurogenic tumors requires histopathological and imaging examinations, which can be challenging, with the exception of cases where surgical biopsy is conducted 4,5 . Although several case reports have previously reported the diagnosis of schwannoma using EBUS‐TBNA alone, 11–15 a retrospective study of 86 neurogenic tumors of the mediastinum reported that the diagnosis was made in 84 cases using surgical specimens; two and three cases in which EBUS‐TBNA and TTB, respectively, were performed did not yield an accurate diagnosis of schwannoma 3 .…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis of neurogenic tumors requires histopathological and imaging examinations, which can be challenging, with the exception of cases where surgical biopsy is conducted. 4 , 5 Although several case reports have previously reported the diagnosis of schwannoma using EBUS‐TBNA alone, 11 , 12 , 13 , 14 , 15 a retrospective study of 86 neurogenic tumors of the mediastinum reported that the diagnosis was made in 84 cases using surgical specimens; two and three cases in which EBUS‐TBNA and TTB, respectively, were performed did not yield an accurate diagnosis of schwannoma. 3 Herein, EBUS‐TBNA with four punctures yielded insufficient specimens for diagnosis, and the addition of EBUS‐IFB using SBFs was diagnostically efficacious.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with small tumors are usually asymptomatic, but subjective symptoms occur as the tumor grows and compresses adjacent vital organs 2,3 . Computed tomography (CT), magnetic resonance imaging, and positron emission tomography (PET)‐CT are used to diagnose schwannomas; however, biopsies such as endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA), endoscopic ultrasound‐guided fine needle aspiration, and transthoracic biopsy (TTB) are necessary for a definitive diagnosis 4,5 . However, the small specimens obtained via EBUS‐TBNA and nonsurgical methods often lack sufficient tumor components, leading to false‐negative results.…”

Section: Introductionmentioning

confidence: 99%

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Schwannoma diagnosed by endobronchial ultrasound‐guided intranodal forceps biopsy using standard‐sized biopsy forceps: A case report

Uchimura,

Ishida,

Kan

et al. 2024

Thoracic Cancer

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Schwannomas are classified as neurogenic tumors and are the most frequent nerve sheath tumors in the paravertebral mediastinum. Recently, the addition of endobronchial ultrasound‐guided intranodal forceps biopsy (EBUS‐IFB) using standard‐sized biopsy forceps (SBFs) to endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) for metastatic lymph nodes in lung cancer patients reportedly improved the quality and quantity of the obtained specimens without significant complications. However, reports on the usefulness of this technique for benign diseases remain scarce. Here we report a case of schwannoma in the middle mediastinum, which was diagnosed by EBUS‐IFB using SBFs, despite inadequate specimens obtained via EBUS‐TBNA. An 80‐year‐old woman presented with dyspnea and a 5‐cm sized middle mediastinal tumor. EBUS‐TBNA and EBUS‐IFB using SBFs were performed for histological diagnosis. No complications were associated with the bronchoscopy procedure, and schwannoma was solely diagnosed using the EBUS‐IFB specimens. EBUS‐IFB using SBFs is potentially useful for diagnosing benign diseases, including schwannomas, which are often difficult to diagnose with EBUS‐TBNA.

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“…4 b); (3) for hemangioma , both of them paid much attention to the obvious internal honeycomb structure and the enhanced echo behind the lesion (Fig. 4 c); (4) for neurinoma [ 31 , 32 ], both of them focused on the “bright cap sign” of the lesions (Fig. 4 d); (5) for epidermal cyst [ 33 , 34 ], both of them were very concerned about the enhancement of the echo behind the lesion (Fig.…”

Section: Discussionmentioning

confidence: 99%

Deep learning models of ultrasonography significantly improved the differential diagnosis performance for superficial soft-tissue masses: a retrospective multicenter study

Long,

Zhang,

Zhang

et al. 2023

BMC Med

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Background Most of superficial soft-tissue masses are benign tumors, and very few are malignant tumors. However, persistent growth, of both benign and malignant tumors, can be painful and even life-threatening. It is necessary to improve the differential diagnosis performance for superficial soft-tissue masses by using deep learning models. This study aimed to propose a new ultrasonic deep learning model (DLM) system for the differential diagnosis of superficial soft-tissue masses. Methods Between January 2015 and December 2022, data for 1615 patients with superficial soft-tissue masses were retrospectively collected. Two experienced radiologists (radiologists 1 and 2 with 8 and 30 years’ experience, respectively) analyzed the ultrasound images of each superficial soft-tissue mass and made a diagnosis of malignant mass or one of the five most common benign masses. After referring to the DLM results, they re-evaluated the diagnoses. The diagnostic performance and concerns of the radiologists were analyzed before and after referring to the results of the DLM results. Results In the validation cohort, DLM-1 was trained to distinguish between benign and malignant masses, with an AUC of 0.992 (95% CI: 0.980, 1.0) and an ACC of 0.987 (95% CI: 0.968, 1.0). DLM-2 was trained to classify the five most common benign masses (lipomyoma, hemangioma, neurinoma, epidermal cyst, and calcifying epithelioma) with AUCs of 0.986, 0.993, 0.944, 0.973, and 0.903, respectively. In addition, under the condition of the DLM-assisted diagnosis, the radiologists greatly improved their accuracy of differential diagnosis between benign and malignant tumors. Conclusions The proposed DLM system has high clinical application value in the differential diagnosis of superficial soft-tissue masses.

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Endobronchial ultrasound-guided transbronchial needle aspiration as a diagnostic modality for schwannoma: A case report

Cited by 4 publications

References 25 publications

Analysis of the prenatal ultrasound diagnostic value and prognostic factors of fetal mediastinal cysts

Analysis of the prenatal ultrasound diagnostic value and prognostic factors of fetal mediastinal cysts

Schwannoma diagnosed by endobronchial ultrasound‐guided intranodal forceps biopsy using standard‐sized biopsy forceps: A case report

Deep learning models of ultrasonography significantly improved the differential diagnosis performance for superficial soft-tissue masses: a retrospective multicenter study

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