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The Use of Endobronchial Ultrasonography With Transbronchial Needle Aspiration To Sample a Solitary Substernal Thyroid Nodule

Michel Chalhoub, MD; Kassem Harris, MD
Author and Funding Information

From the Staten Island University Hospital, Staten Island, NY.

Correspondence to: Michel Chalhoub, MD, Staten Island Pulmonary Associates, 501 Seaview Ave, Ste 102, Staten Island, NY 10305; e-mail: chalhoubmichel@gmail.com


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(6):1435-1436. doi:10.1378/chest.09-2840
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Solitary thyroid nodules (STNs) are frequently encountered in clinical practice. When sampling of an STN is deemed necessary, ultrasound-guided fine needle aspiration biopsy (US-FNAB) is the procedure of choice. In substernal STNs, US-FNAB is not feasible, and the patients are usually offered either more invasive diagnostic testing (mediastinoscopy or surgical excision) or follow-up imaging studies based on the clinical suspicion of malignancy. We report a case in which a substernal STN was sampled using endobronchial ultrasonography with transbronchial fine needle aspiration (EBUS-TBNA). Our patient is a 74-year-old woman who was admitted with an asthma exacerbation. She underwent a chest CT scan with intravenous contrast (CTA) to rule out pulmonary embolism (PE). The CTA was negative for PE but showed a substernal STN that was successfully sampled by EBUS-TBNA without complications. The cytology was consistent with a colloid adenoma. EBUS-TBNA can sample substernal STNs that are not amenable to US-FNAB.

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