[Pulmonary embolism diagnosed during an endobronchial ultrasound procedure]

Pulmonary embolism occurs frequently in lung cancer. The clinical features are non-specific and the diagnosis is often missed.

A 60-year old man presented with a right upper lobe mass associated with right hilar adenopathy. Both had activity on positron emission tomography. As bronchoscopy was normal, an endobronchial, ultrasound guided, transbronchial needle aspiration (EBUS-TBNA) was performed to obtain a diagnosis. During the procedure, a hypoechogenic image was seen in the right pulmonary artery. A CT pulmonary angiogram confirmed the diagnosis of right pulmonary embolism. The transbronchial needle aspiration confirmed the neoplastic nature of the adenopathy. To our knowledge, this is the first description of a pulmonary embolism diagnosed by EBUS. This observation confirms the results of a recently published study showing that known pulmonary embolism can be detected by EBUS.

Although EBUS is not the classic tool for the diagnosis of pulmonary embolism, it seems advisable to undertake a careful examination of the proximal pulmonary artery during an EBUS procedure.