The representative case is that of an 81-year old female, non-smoker, with a 35 mm pure ground glass opacity (GGO) in the right lower lobe that was incidentally seen on computed tomography (CT) scan of the chest (Fig. 1A) but was indistinct on chest radiograph (Fig. 1B). The endobronchial route was carefully planned prior to bronchoscopy using 1-mm cross-sectional CT scan images and the topographical location of the target lesion on the coronal plane was mapped out on chest tomosynthesis. The patient underwent diagnostic bronchoscopy (1T260, Olympus) using radial EBUS (UM-S20-20R, Olympus) with large type GS (K-203, Olympus). Fluoroscopy was used concomitantly with endobronchial ultrasound scanning to find the target. During the initial attempt, it was difficult to distinguish the mass on fluoroscopy (Fig. 2A) and ultrasound signals only generated a snowstorm appearance that was ascribed as normal lung tissue (Fig. 2B). But we were certain that we were in the intended lung segment so the ultrasound probe was inserted more distally. At this point, a subtle but noticeable enhancement and increase in area of the snowstorm appearance was seen (Fig. 2C). After marking this location of the GS on fluoroscopy, seven TBB samples were obtained using a dedicated biopsy forceps with guide sheath kit (Fig. 2D). Histopathologic examination of the 3rd to the 7th consecutive biopsy specimens revealed adenocarcinoma with lepidic growth (Fig. 3). The patient was staged as T2aN0M0 but refused further treatment.