Bronchogenic Cyst Rupture and Pneumonia after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Case Report

Abstract

We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA.

Endobronchial ultrasound‐guided transbronchial needle aspiration: Safe as it sounds

“…Another patient with squamous cell carcinoma of lung developed tumour bed contamination post‐EBUS‐TBNA . Bronchogenic cyst rupture and pneumonia have been reported following EBUS‐TBNA for diagnosis of bronchogenic cyst . The AQuIRE study did not report any infective complications …”

“…However, this risk is not reported by other studies . Although, EBUS‐TBNA has been used for aspiration of bronchogenic cysts has been reported, this application is debated due to the risk of complications …”

“…6,11 Although, EBUS-TBNA has been used for aspiration of bronchogenic cysts has been reported, this application is debated due to the risk of complications. 30,51 The other reported complications of EBUS-TBNA include pericarditis, mediastinitis, pneumothorax, respiratory failure and death. CT scan of thorax or combined PET-CT of thorax may help identify the site and extent of the infection that may occur after EBUS-TBNA.…”

“…39 Bronchogenic cyst rupture and pneumonia have been reported following EBUS-TBNA for diagnosis of bronchogenic cyst. 30 The AQuIRE study did not report any infective complications. 6…”

“…Al Qadi and Maldonado 25 2014 Case report Tracheal stenosis 1 12 Jang et al 26 2014 Case report Malignant pleural effusion 1 13 Hata et al 27 2013 Case report Intrabronchial polyp; sputum positive for tuberculosis post-EBUS-TBNA 2 14 Lee et al 28 2013 Case report Endotracheal granuloma 1 15 Miller et al 29 2013 Letter to editor Fatal haemorrhage 1 16 Hong et al 30 2013 Case report Cyst rupture; pneumonia 1 17 Gochi et al 31 2013 Case report Mediastinitis 1 18 Dhillon and Yendamuri 32 2013 Case report Needle assembly malfunction 2 19 Huang et al 33 2011 Case report Mediastinitis, empyema, lung abscess 1 20 Gomez et al 34 2010 Case report Sputum positive for tuberculosis post-EBUS-TBNA 1 21 Gupta et al 35 2010 Case report Endobronchial polyp 1 22…”