CASE PRESENTATION: We present the case of a 51 year old man, with a history of metastatic rectal adenocarcinoma, (cT2N3M1 with liver metastasis). A PET-TC showed a PET positive left hilar lesion. Evaluation by a multidisciplinary tumor board, decided that the lesion was suspicious of malignancy and warranted further investigation to differentiate metastasis versus primary lung cancer. An EBUS procedure was performed and an anechoic structure was seen between the left main bronchial wall and the target node. This was the only window to visualize the lesion. Doppler examination confirmed flow within the hypoechoic structure, which along with the location allowed it to be positively identified as the pulmonary artery. TBNA of the node was performed with a 22 G needle. Final cytological examination of the sample showed metastatic rectal adenocarcinoma.