In recent years, endoscopy units have introduced the use of endobronchial ultrasound (EBUS) with a convex probe that allows for real-time transbronchial needle aspiration (TBNA) of mediastinal and hilar lymph nodes guided by ultrasound images.1 This technique, known as real-time EBUS–TBNA, is minimally invasive and has the potential to replace mediastinoscopy.2 In some models of EBUS–TBNA needle, the metal stylet must be retracted so that the puncture can be made through the tracheal or bronchial wall. The round stylet knob must be pulled back a few millimeters, in order to expose the sharp needle tip. If it is not slightly withdrawn, the needle tip will be occupied by the blunt stylet, complicating penetration through the bronchial. Indeed, in this situation some cartilage fragment is sometimes dragged and lodged inside the lymph node (Fig. 1). For this reason, it is advisable to redirect the needle in order to avoid the obstruction caused by any cartilage that may lie in front of the needle when obtaining the aspirate.
We report the case of a patient who underwent lymphadenectomy two weeks after undergoing EBUS–TBNA. The lower paratracheal node biopsy shows anthracotic pigment in macrophages and contains two fragments of cartilage, as observed in the pathology image.
Please cite this article as: Martín-Ontiyuelo C, Pijuan L, Sánchez-Font A. Fragmento de cartílago, detectado en un ganglio linfático, tras punción aspirativa transbronquial guiada con ultrasonografía endobronquial (EBUS-TBNA). Arch Bronconeumol. 2016;52:560.
