Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) combined with a three-way stopcock for mediastinal cysts through negative pressure drainage: a case report.

Xiaoting Cai, Chendi Fei, Shiman Pang, Chunli Tang, Shiyue Li

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Article in AME case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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Xiaoting CaiDepartment of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.

Chendi FeiDepartment of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.

Shiman PangDepartment of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.

Chunli TangDepartment of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.

Shiyue LiDepartment of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.

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6 · The paper itself

Abstract

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can extract cystic fluid for diagnosis, but evidence is mainly limited to case reports with infection risk. Against this background, we will report the clinical case that explores the improvement strategy of EBUS-TBNA combined with a three-way stopcock device to reduce infection rates and review the relevant literature, using the search term '(((endobronchial ultrasound-guided transbronchial needle aspiration) OR (EBUS-TBNA)) AND ((cysts) OR (mediastinal cysts) OR (bronchogenic cysts)))' from PubMed. Case Description: A 66-year-old female patient presented with exertional dyspnea, and computed tomography (CT) showed a 59 mm × 53 mm cystic lesion in the right upper posterior mediastinum, which was treated by EBUS-TBNA (utilizing a 22-gauge needle and a three-way stopcock), successfully aspirating 170 mL of clear yellow fluid. Postoperative tracheal compression was relieved with immediate symptomatic relief. No recurrence or complications were observed during the 3-month postoperative follow-up. Additionally, a total of 22 papers were included. Among 20 case reports (49 cases), 17 improved, 16 required surgery, and 7 had postoperative infections. Conclusions: While EBUS-TBNA serves as a valuable diagnostic and therapeutic tool for cystic lesions, postoperative infection remains a significant concern, particularly during necrotic cavity puncture. EBUS-TBNA combined with negative pressure drainage of the three-way stopcock optimizes the workflow to prevent spillage and may potentially mitigate infection risks by maintaining a closed system. While long-term outcomes require further observation, this technique may represent a feasible adjunct to EBUS-TBNA in selected patients with mediastinal cystic lesions.

Indexed as

bronchogenic cystscase reportEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)mediastinal cyststhree-way stopcock

Identifiers

PMID42299386

DOI10.21037/acr-2025-306

PMCPMC13264758

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LicenceCC BY-NC-ND

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