Major airway laceration secondary to endobronchial ultrasound transbronchial lymph node biopsy

A 48-year-old woman underwent complete mediastinal lymph node staging for non-small-cell lung cancer. After convex endobronchial ultrasound (EBUS)-guided transbronchial biopsy of the subcarinal lymph node station (station no. 7), it was noted that a laceration had occurred in the left mainstem bronchus. The tear occurred at the medial cartilaginous-membranous junction, seemed to be full thickness into the mediastinum, and was approximately 1.5cm long. The cytologic results of all lymph node biopsies were negative and the patient underwent right upper and middle lobe bilobectomy 12 hours after the EBUS procedure. This is the first report of a serious airway injury occurring during convex EBUS lymph node biopsy.