Key result
EBUS-TBNA successfully diagnoses urothelial carcinoma metastasis in the pulmonary artery.
Why the study?
Tumours within pulmonary arteries pose a diagnostic challenge because they resemble pulmonary emboli, and the optimal sampling approach is often unknown.
EBUS-TBNA is a feasible and safe minimally invasive technique for diagnosing central pulmonary artery tumor emboli when other methods fail.
Tumours within the pulmonary arteries provide a diagnostic challenge due to their similar appearance to pulmonary emboli. Often, the decision to sample is multidisciplinary and the best approach to take is often unknown. Here we describe a case of urothelial carcinoma which metastasised to the mediastinum with evidence of tumour burden within the pulmonary artery. Sampling of this by endovascular and thoracoscopic means was unsuccessful; however, we were able to provide a diagnosis using direct visualization with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). This report is the first of a central pulmonary artery tumour caused by urothelial carcinoma biopsied by EBUS-TBNA in the English literature. We describe the diagnostic challenges and steps in evaluating suspected tumour emboli with a focus on transbronchial needle aspiration.
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Admire et al. (2026) studied this question. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) successfully diagnosed urothelial carcinoma metastasis in the pulmonary artery, overcoming significant diagnostic challenge.
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