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

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.