The potential for complication from thyroid nodule biopsy via EBUS-TBNA is highlighted in the following case. A 49-year-old woman was referred for EBUS-TBNA of asymptomatic mediastinal adenopathy with a history of low-grade endometrial sarcoma resected through hysterectomy 3 months prior. At the time of surgery, small-volume mediastinal adenopathy and lung nodules were identified. On follow-up CT imaging, adenopathy had increased in size. A thyroid nodule was also identified (Fig 1A). Thus, the patient underwent airway inspection (normal) and EBUS-TBNA. Sampling of a 9-mm subcarinal lymph node identified noncaseating granuloma consistent with sarcoid-like lymphadenopathy on two passes, and follow-up CT imaging 3 months later identified stable disease. The thyroid nodule was also sampled through EBUS-TBNA, and cytologic analysis identified colloid consistent with a benign nodule. The patient presented to the ED 8 days later with fever and swelling and pain in her neck. Ultrasonography of her neck identified a thyroid abscess, which was drained (Fig 1B). She was treated with IV antibiotics, and repeat ultrasound-guided drainage was required 48 h later. Thyroid aspirate cultures grew Streptococcus mitis and mixed gram-positive and gram-negative organisms sensitive to penicillin. Mycobacterial staining and cultures of the abscess and mediastinal lymph node were negative. She was discharged without recurrence of symptoms, and follow-up thyroid function testing was normal.