title: The use of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of thyroid lesions.
abstract: BACKGROUND
  Non-palpable thyroid nodules can be difficult to access by conventional ultrasound-guided fine needle aspiration, particularly when they are intrathoracic. Many of these patients are subject to multiple follow up scans or invasive diagnostic procedures such as mediastinoscopy or surgical resection. We aim to describe the feasibility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for diagnosis of thyroid lesions.
  
  
  METHODS
  All EBUS-TBNA performed at our institutions from February 2010 to February 2013 were screened, and those in which a thyroid biopsy was performed were reviewed.
  
  
  RESULTS
  We identified 12 cases of EBUS-TBNA thyroid biopsy. Nine patients had an indication for EBUS in addition to their thyroid lesions. The median age was 64 years (range 44 to 84 years), and 10 patients were male. Median lesion size was 22.5 mm (range, 10 to 43 mm). Five lesions were strictly intrathoracic. All cases were sampled with a 22G needle and rapid on-site cytologic examination. Adequate samples were obtained in all 12 cases. Malignancy was identified in 3 of the 12 patients (metastatic breast adenocarcinoma, large B-cell lymphoma, and metastatic lung adenocarcinoma). The remaining 9 samples were deemed to be benign nodules. Seven of these were confirmed by clinical follow-up (n = 3), biopsies (n = 3), or surgery (n = 1).There were no EBUS-related complications.
  
  
  CONCLUSIONS
  EBUS-TBNA might be a safe and effective alternative for sampling thyroid lesions, particularly useful for those located below the thoracic inlet. Further prospective studies are required to compare its diagnostic yield and safety profile with standard techniques.
authors.affiliation: Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Michael E, DeBakey VA Medical Center, 2002 Holcombe Blvd, Pulmonary Section 111i, Houston, TX 77030, USA. casal@bcm.edu.
authors.forename: Roberto F
authors.initials: RF
authors.lastname: Casal
authors.forename: Mimi N
authors.initials: MN
authors.lastname: Phan
authors.forename: Keerthana
authors.initials: K
authors.lastname: Keshava
authors.forename: Jose M
authors.initials: JM
authors.lastname: Garcia
authors.forename: Horiana
authors.initials: H
authors.lastname: Grosu
authors.forename: D Ray
authors.initials: DR
authors.lastname: Lazarus
authors.forename: Juan
authors.initials: J
authors.lastname: Iribarren
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Rosen
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000295:instrumentation / Q000379:methods; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D001999:Bronchoscopy; D003362:Cost-Benefit Analysis; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018084:Ultrasonography, Interventional