Primary Mediastinal T-Lymphoblastic Lymphoma With Airway Stenosis Diagnosed Using Endobronchial Ultrasound-Guided...

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for sampling mediastinal lesions but may be inadequate for diagnosing lymphoma because of limited tissue acquisition. We report a case of T-lymphoblastic lymphoma (T-LBL) successfully diagnosed using endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-Cryo). An 18-year-old woman presented with an anterior mediastinal mass causing severe tracheal compression. EBUS-TBNA followed by EBUS-Cryo using a 1.1-mm cryoprobe was performed under endotracheal intubation without complications. Although EBUS-TBNA specimens were nondiagnostic because of crush artefacts and blood contamination, EBUS-Cryo yielded well-preserved tissue, enabling comprehensive immunohistochemical evaluation and a definitive diagnosis of T-LBL. This case demonstrates that EBUS-Cryo can provide sufficient tissue for diagnosing mediastinal T-LBL and may be safely performed in carefully selected patients, even in the presence of substantial airway compression.