Convex-probe endobronchial ultrasound-guided cryobiopsy for pleural tumors: three case reports

Background: Endobronchial ultrasound-guided cryobiopsy (EBUS-cryo) is an emerging minimally invasive technique that enables acquisition of high-quality tissue specimens, particularly from mediastinal lymphadenopathy. Here, we describe three cases in which its application to pleural tumors helped establish a definitive diagnosis. Case Description: Case 1 involved a 74-year-old man with multiple pleural lesions detected via computed tomography (CT), the largest of which was encased by major vessels. EBUS-cryo sampling of the largest lesion, performed through the left lower bronchus, led to the diagnosis of epithelioid pleural mesothelioma. Case 2 involved a 69-year-old man with multiple pleural masses encircling the mediastinal aspect of the right lung without associated pleural effusion. EBUS-cryo sampling of a pleural lesion located along the right dorsal side of the trachea led to the diagnosis of biphasic pleural mesothelioma. Case 3 involved an 82-year-old man with multiple pleural lesions and consolidation in the left upper lobe. Semi-rigid pleuroscopy could not establish a definitive diagnosis; however, EBUS-cryo performed on a mediastinal pleural tumor through the left posterior trachea established a diagnosis of B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) type. Conclusions: EBUS-guided cryobiopsy of pleural tumors may represent a generally safe minimally invasive option for obtaining diagnostic tissue in selected patients.