@article{oai:repository.lib.tottori-u.ac.jp:00005006,
 author = {Miwa, Ken and Miwa, Ken and Nakamura, Hiroshige and Nakamura, Hiroshige and Kubouchi, Yasuaki and Matsuoka, Yuki and Yurugi, Yohei and Takagi, Yuzo and Takagi, Yuzo and Haruki, Tomohiro and Haruki, Tomohiro and Fujioka, Shinji and Taniguchi, Yuji and Kubouchi, Yasuaki and Matsuoka, Yuki and Yurugi, Yohei and Fujioka, Shinji and Taniguchi, Yuji},
 issue = {4},
 journal = {Yonago Acta medica, Yonago Acta medica},
 month = {Dec},
 note = {We report a 58-year-old man who suffered from shortness of breath on exertion with wheezing. A chest enhanced computed tomography (CT) scan showed an irregular tumor in the middle mediastinum involving the right main pulmonary artery, vena cava superior and right main bronchus. Transbronchial lung biopsy and endobronchial ultrasoundguided transbronchial needle aspiration yielded no evidence for a pathological diagnosis of malignancy. We employed mediastinoscopy, which led to a diagnosis of lymphoid reactive change. 18F-fluorodeoxyglucose-positron emission omography (FDG-PET) scan revealed a high FDG uptake in the tumor lesion. Because the CT scan and FDG-PET findings led to a marked suspicion of malignancy, we decided to attempt biopsy by a video-assisted thoracoscopic surgery (VATS) approach. Flow cytometry showed a monoclonal pattern, and the final diagnosis was mediastinal follicular lymphoma both pathologically and immunohistologically. The patient achieved a complete remission by following chemotherapy. Lowgrade malignancy type of lymphoma such as follicular lymphoma that generally contains small-cell components often presents a diagnostic challenge and the VATS approach was effective for the diagnosis of such type of mediastinal lymphoma.},
 pages = {83--86},
 title = {Mediastinal Malignant Lymphoma Difficult to Diagnose : A Patient Report},
 volume = {54},
 year = {2011}
}