EBUS-guided cryobiopsy in the diagnosis of thoracic disorders

• Published in: Pulmonology Vol. 30; no. 5; pp. 459 - 465
• Main Authors: Poletti, V., Petrarulo, S., Piciucchi, S., Dubini, A., De Grauw, A.J., Sultani, F., Martinello, S., Gonunguntla, H.K., Ravaglia, C.
• Format: Journal Article
• Language: English
• Published: Spain Elsevier España, S.L.U 01.09.2024
• Subjects: Adult; Aged; Bronchoscopy - methods; EBUS-guided cryobiopsy; EBUS-TBNA; Endobronchial ultrasound; Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods; Endosonography - methods; Female; Humans; Lung Neoplasms - diagnosis; Lung Neoplasms - pathology; Lymphadenopathy - diagnosis; Lymphadenopathy - pathology; Lymphoproliferative Disorders - diagnosis; Lymphoproliferative Disorders - pathology; Male; Mediastinal cryobiopsy; Mediastinal Diseases - diagnosis; Mediastinal Diseases - pathology; Mediastinal tumors; Mediastinum - pathology; Middle Aged; Retrospective Studies; Sarcoidosis - diagnosis; Sarcoidosis - pathology; Thoracic Diseases - diagnosis; Thoracic Diseases - pathology; SCLC; PA; NSCLC; Mediastinal cryobiopsy; IHC; Mediastinal tumors; EBUS-TBNA; EBUS-TMC; EBUS-guided cryobiopsy; NGS; Endobronchial ultrasound
• ISSN: 2531-0437; 2531-0437
• DOI: 10.1016/j.pulmoe.2023.11.008

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. 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. 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. 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. 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.