What happened, in summary

A 64-year-old man with emphysema and angina was evaluated for a left upper-lobe lung mass. PET imaging showed activity in the lung mass and left hilar lymph nodes. He underwent endobronchial ultrasound-guided needle sampling to diagnose and stage the suspected cancer.

Despite sedation and local anesthesia, he coughed heavily throughout the procedure. After 3 needle passes into the left hilar node, bleeding began spontaneously from both ears. The procedure was stopped, and an ear, nose, and throat specialist assessed him. He remained stable and had no hearing loss or damage to the eardrums. The bleeding did not recur and required observation only.

The lymph-node samples confirmed pulmonary adenocarcinoma. He then received chemotherapy followed by radical radiotherapy and remained under active oncology follow-up.

The ear bleeding was attributed to a rare pressure-related complication from forceful coughing during the diagnostic procedure, rather than to the cancer or its treatment.