Endobronchial ultrasound-guided transbronchial needle aspiration under non-invasive positive pressure for the diagnosis of lung metastasis due to renal cell carcinoma in a patient with respiratory failure

A 65-year-old man with chronic respiratory failure caused by chronic obstructive pulmonary disease, had a pulmonary nodule adjacent to the inlet of right B1 and B3. The patient had undergone a surgery for right renal cell carcinoma and colon cancer 6 years prior. We attempted endobronchial ultrasound-guided transbronchial needle aspiration under non-invasive positive pressure ventilation for diagnosis, with rapid on-site cytology, which was performed without complications. The histological findings revealed lung metastasis involving renal cell carcinoma. Endobronchial ultrasound-guided transbronchial needle aspiration under non-invasive positive pressure ventilation is useful for diagnosing lesions that require access up to the segmental bronchus in patients with respiratory failure.