Isolated Mediastinal and Hilar Lymphadenopathy as a Manifestation of IgG4‐Related Disease Diagnosed by EBUS‐Guided Transbronchial Mediastinal Cryobiopsy

TL;DR

A case of IgG4-related disease was diagnosed using a new cryobiopsy technique in the mediastinum, offering a minimally invasive alternative.

Contribution

Demonstrates the successful use of transbronchial mediastinal cryobiopsy for diagnosing IgG4-related disease.

Findings

Transbronchial mediastinal cryobiopsy successfully diagnosed IgG4-related disease in a patient with lymphadenopathy.

The technique fulfilled 2020 diagnostic criteria after ruling out infections and lymphoproliferative disorders.

Systemic evaluation confirmed no involvement of other organs in the patient.

Abstract

Immunoglobulin G4‐related disease (IgG4‐RD) is a fibroinflammatory condition that can involve multiple organs, including mediastinal lesions. Transbronchial mediastinal cryobiopsy has recently emerged as a novel sampling technique that improves diagnostic yield for mediastinal lesions, particularly in rare tumours and benign disorders, compared to endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA). Here we report a case of IgG4‐RD presenting with hilar and mediastinal lymphadenopathy successfully diagnosed by transbronchial mediastinal cryobiopsy using a ø1.7 mm cryoprobe. The diagnosis was established in accordance with the 2020 revised comprehensive diagnostic criteria for IgG4‐RD, after exclusion of infectious and lymphoproliferative disorders. Endoscopic mediastinal cryobiopsy may represent a valuable and minimally invasive strategy for diagnosing mediastinal diseases.

We describe a case of mediastinal and hilar lymphadenopathy diagnosed as IgG4‐RD by transbronchial mediastinal cryobiopsy, fulfilling the 2020 diagnostic criteria, with systemic evaluation confirming no other organ involvement.

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