The new transbronchial diagnostic approach for the metastatic lung tumor from renal cell carcinoma-a case report.

Endobronchial ultrasound-guided needle aspiration (EBUS-TBNA) is a well-established procedure with high diagnostic yield and safety. However, the standard 22 gauge needles sometimes cause major bleeding particularly in hypervascular tumors like metastatic lung tumors from renal cell carcinoma (RCC). The 25 gauge needles are already introduced to endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), and are considered as one of the standard devices due to their comparable diagnostic outcome, lower complication risk, and the better manipulability. Recently, the new 25 gauge needles have been applied to EBUS-TBNA. In present case, we were able to obtain a definitive diagnosis of the metastatic RCC by EBUS-TBNA using the 25 gauge needle. The new thin needle might be a better option for hypervascular tumors of the lung.