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Chest. 2010 Jun;137(6):1435-6. doi: 10.1378/chest.09-2840.

The use of endobronchial ultrasonography with transbronchial needle aspiration to sample a solitary substernal thyroid nodule.

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  • 1Staten Island Pulmonary Associates, 501 Seaview Ave, Ste 102, Staten Island, NY 10305, USA.


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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