Supplementary Material for: Endobronchial Ultrasound-Guided Transbronchial Incision and Resection of Calcified Lymph Nodes: A Minimally Invasive Approach to Airway Stenosis

Introduction: Although mediastinal lymph node calcification often remains clinically silent, its compressive effects on vital structures, such as the trachea or bronchi, may necessitate intervention. Traditional surgical resection can be risky for certain patients. We present a pioneering case in which endobronchial ultrasound (EBUS)-guided transbronchial resection effectively relieved bronchial obstruction caused by calcified lymph nodes.
Case Presentation: A 59-year-old male with a history of treated tuberculosis presented with a 4-month history of persistent cough, sputum, and dyspnea. Imaging revealed calcified mediastinal lymph nodes compressing the right intermediate bronchus, with mucus plug formation and obstructive pneumonia. The patient declined surgery; hence, an EBUS-guided transbronchial resection was performed under general anesthesia. Two calcified lymph nodes were removed using a high-frequency needle knife and forceps under real-time ultrasound guidance. No perioperative complications occurred. The patient's respiratory symptoms resolved, and follow-up bronchoscopy at 4 months showed a fully healed airway without restenosis.
Conclusion: This case highlights the feasibility and safety of EBUS-guided transbronchial resection as a minimally invasive treatment for symptomatic mediastinal lymph node calcification. EBUS has potential as a viable alternative for patients in whom thoracic surgery is contraindicated or declined.