EBUS-guided cryobiopsy in the diagnosis of thoracic disorders

Pulmonology

Available online 5 January 2024

PulmonologyAuthor links open overlay panel, , , , , , , , AbstractBackground

Endobronchial Ultrasound (EBUS) has emerged as a crucial tool for diagnosing intrathoracic disorders, particularly in the staging of lung cancer. However, its diagnostic capabilities in the context of benign and rare diseases remain a subject of debate.

Aim

to investigate the diagnostic yield and safety of EBUS-transbronchial mediastinal cryobiopsy (EBUS-TMC) in comparison to EBUS-transbronchial needle aspiration (TBNA) for a broad spectrum of intrathoracic diseases.

Methods

a single-centre retrospective observational study conducted on 48 patients who underwent both EBUS-TBNA and endobronchial ultrasound-transbronchial mediastinal cryobiopsy (EBUS-TMC) in the same procedure between August 2021 and October 2023.

Results

The overall diagnostic yield of EBUS-TMC surpassed that of EBUS-TBNA (95.8% vs 54.1 %), notably excelling in the diagnosis of sarcoidosis (92.8% vs 78.5 %), rare mediastinal disorders (100% vs 0 %), hyperplastic lymphadenopathy (100% vs 0 %), and lymphoproliferative disease (100% vs 0 %). No significant differences were observed in the diagnosis of NSCLC and SCLC. Samples obtained through EBUS-TMC facilitated the acquisition of NGS and immunohistochemical analyses more readily.

Conclusion

EBUS-TMC may contribute to the precise diagnosis and subtyping of mediastinal diseases, especially lymphomas and rare mediastinal tumors, thereby reducing the number of non-diagnostic procedures.

Keywords

Endobronchial ultrasound

EBUS-TBNA

EBUS-guided cryobiopsy

Mediastinal tumors

Mediastinal cryobiopsy

AbbreviationsEBUS-TBNA

Endobronchial ultrasound- transbronchial needle aspiration

EBUS-TMC

Endobronchial ultrasound- transbronchial mediastinal cryobiopsy

NGS

next generation sequencing

NSCLC

non-small cell lung cancer

SCLC

small cell lung cancer

© 2023 Published by Elsevier España, S.L.U. on behalf of Sociedade Portuguesa de Pneumologia.

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