“Endobronchial ultrasound: beyond nodes and masses” o Respirology Case Reports Volume 3, Issue 4, pages 141– 144, December 2015

Pulmonary embolism (PE) is a medical emergency with high morbidity and mortality. Regularly revised guidelines have proposed a systematic diagnostic and management protocol. Despite best recommendations, there are clinical situations where PE poses a clinical challenge in diagnosis and management.

Clinical prediction scores, D-Dimer, computed tomography pulmonary angiography (CTPA), lung scintigraphy, magnetic resonance (MR) angiography, compression venous ultrasound and echocardiography are various diagnostic procedures proposed. But it still remains difficult to diagnose PE in conditions such as renal failure, pregnancy and in hemodynamically unstable patients.

Convex probe endobronchial ultrasound (EBUS) has been used for mediastinal lymphadenopathy and adjacent masses. Doppler assessment of mediastinal vasculature by EBUS has recently been mentioned for diagnosis of central PE 1, 2. Previous studies evaluated EBUS as a diagnostic tool for PE and compared it with CTPA. In our case due to various comorbid conditions and medical limitations, EBUS was considered as the test to ascertain PE.