A 57-year-old woman, a non-smoker with obesity, diabetes mellitus (DM), hypertension (HTN), and asthma, was hospitalized for symptomatic bilateral pulmonary embolism (PE) confirmed by a chest CTA. The CT also demonstrated a left upper lobe (LUL) nodule with hilar and mediastinal lymphadenopathy (LAD). Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of the mediastinal lymph nodes, transbronchial biopsy (TBBX) of the LUL nodule, and CT-guided biopsy of the L1 vertebral body all revealed non-necrotizing granulomas. A comprehensive workup for infection and malignancy was negative.
Interesting case indeed! How was transbronchial biospy taken from LUL nodule ? Was it blind or radial EBUS guided?