The patient is a 58 year old woman who presented with several months of dysphagia and atypical chest pain. Endoscopy was attempted but was unsuccessful due to extrinsic compression of the esophagus. CT scan showed a well-circumscribed 3.2 x 2.7 x 2.6 cm mass in the mediastinum, inferior to the carina. Endobronchial ultrasound guided FNA was performed to sample the mass.