Tracheal Schwannoma Diagnosed by Endobronchial Ultrasound-Guided Intranodal Forceps Biopsy (EBUS-IFB)

Definitively diagnosing submucosal airway lesions is often challenging because conventional endobronchial forceps biopsies cannot access the deeper tissues. Endobronchial ultrasound-guided intranodal forceps biopsy (EBUS-IFB) has improved diagnostic yield for mediastinal lymph nodes; however, its application to submucosal airway lesions has not been reported. A 72-year-old man was referred to our institution because of a tracheal tumour incidentally discovered via computed tomography. Bronchoscopy revealed a broad-based, smooth-surfaced, elevated lesion involving the deep subepithelial to intramural layers. EBUS-transbronchial needle aspiration (TBNA) followed by EBUS-IFB via the puncture tract was performed. Although TBNA was inconclusive, the EBUS-IFB specimen preserved the tissue architecture with palisading spindle cells positive for S-100 and SOX10, confirming tracheal schwannoma. No complications occurred. This case suggests that EBUS-IFB may be a feasible diagnostic option for selected predominantly submucosal airway lesions when conventional sampling is inconclusive.