Hilar lymph node eroding into the pulmonary artery diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration

Abstract

Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is a novel minimally invasive procedure useful for the evaluation and diagnosis of mediastinal lymph nodes and the lung parenchymal lesions. A 75-year-old woman diagnosed as a case of infiltrating duct adenocarcinoma of left breast 15 years back for which she underwent a modi fied radical mastectomy followed by radiotherapy and chemotherapy. The patient presented to us with haemoptysis. During EBUS, the enlarged left hilar lymph node was seen to be eroding into the left pulmonary artery leading to a filling defect in the left pulmonary artery. This filling defect was first sampled by EBUS-guided TBNA followed by sampling of left hilar lymph node. The results of cytomorphology revealed malignancy which was compatible with a metastasis from a carcinoma breast. EBUS-TBNA is a novel, safe and minimally invasive procedure with a few complications. Copyright 2012 BMJ Publishing Group. All rights reserved.