Pleural mesothelioma: When echo‐endoscopy ( <scp>EUS‐B‐FNA</scp> ) leads to diagnosis in a minimally invasive way

Malignant pleural mesothelioma (MPM) is an asbestos‐related and locally invasive tumor with poor prognosis. The acquisition of histological material is mandatory in order to establish a diagnosis. In this situation, the sampling of tissue is generally performed via a thoracoscopic pleural biopsy, either medically or surgically. The use of endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) or transesophageal fine needle aspiration with an EBUS scope (EUS‐B‐FNA) of pleural lesions have only rarely been reported due to the theoretical limitations of tissue acquisition in such cases. We herein report a rare case of MPM successfully diagnosed via EUS‐B‐FNA in a 49‐year‐old woman with an unusual presentation characterized by solid thickening in the right mediastinal pleura.
We present a rare case of MPM successfully diagnosed via EUS‐B‐FNA. The use of EUS‐B‐FNA and EBUS‐TBNA for pleural sampling is unusual because the standard approach to pleuropathy is a pleural effusion analysis followed by thoracoscopy or image‐guided pleural biopsy. However, when one or more pleural lesions are near to the central airway or esophagus, EUS‐B FNA and/or EBUS‐TBNA should be considered and one of them chosen because of their simplicity and safety.