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Here we describe a case of urothelial carcinoma which metastasised to the mediastinum with evidence of tumour burden within the pulmonary artery. Sampling of this by endovascular and thoracoscopic means was unsuccessful; however, we were able to provide a diagnosis using direct visualization with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). This report is the first of a central pulmonary artery tumour caused by urothelial carcinoma biopsied by EBUS-TBNA in the English literature. We describe the diagnostic challenges and steps in evaluating suspected tumour emboli with a focus on transbronchial needle aspiration.<\/jats:p>","DOI":"10.1136\/bcr-2025-268157","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T14:35:28Z","timestamp":1767969328000},"page":"e268157","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transvascular endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to confirm urothelial carcinoma metastasis to the pulmonary artery"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2231-3564","authenticated-orcid":false,"given":"Kyle","family":"Admire","sequence":"first","affiliation":[{"name":"Pulmonary and Critical Care, Eastern Virginia Medical School at Old Dominion University, Norfolk, Virginia, 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