Transesophageal bronchoscopic ultrasound-guided fine-needle aspiration for diagnosis of peripheral lung cancer

Peripheral lung cancer is still a diagnostic challenge. The transbronchial approach with bronchoscopy or the transthoracic approach with radiologic imaging has been used extensively for the pathologic diagnosis of peripheral lung cancer. However, the explorability or feasibility with these modalities depends on the lesion location or patient's respiratory function. Herein, we report a case with severe pulmonary emphysema and lung cancer located at a parenchymal region difficult to access through an airway with a bronchoscope. Successful diagnosis was obtained by a transesophageal ultrasound-guided needle aspiration using an endobronchial ultrasound bronchoscope. This technique is accurate and less invasive in the primary diagnosis of lung cancer adjoining the esophagus.