When needles are not enough, forceps delivers!

A 35-year-old male with a history of recurrent pleuritic chest pain was referred for evaluation of a mediastinal mass detected on CT. MRI showed a 10.5 x 7 x 3 cm lesion in the posterior mediastinum. EUS revealed a multicystic lesion with thin septa and clear anechoic content that extended from the lower posterior mediastinum to the upper retroperitoneum. EUS-FNA was performed using a 22-gauge needle with aspiration of a serosanguineous fluid. Fluid analysis showed low values of amylase, triglycerides, CEA, and CA19-9. Cytology tests identified small mature lymphocytes without malignancy.