Accidental breakage of needle tip during endobronchial ultrasound-guided transbronchial needle aspiration: A case report and review of literature

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is commonly recommended for the diagnosis of mediastinal lymphadenopathy with malignant and nonmalignant etiology. EBUS-TBNA has been preferred over mediastinoscopy because of several advantages such as comparable diagnostic accuracy, safety, cost-effectiveness, and less invasiveness. Hemorrhage, mediastinitis, pneumonia, mediastinal abscess, empyema, lung abscess, pericarditis, and pneumothorax have been reported as major complications of EBUS-TBNA. Equipment malfunction has been observed mostly in the form of breakage of EBUS scope parts such as working channel, optical fibers, and ultrasound probe. Needle malfunction either involving assembly leading to inability to retract the needle within the sheath or accidental breakage of the needle tip has also been reported but the evidence is still limited. We encountered an accidental breakage of needle tip while performing EBUS-TBNA procedure in a 58-year-old male having subcarinal lymphadenopathy suspected to have lung cancer. We were able to successfully retrieve the broken fragment bronchoscopically without any complications.