Related Experiment Video
Updated: Jan 1, 2026
Author Spotlight: Demonstrating Systematic Endobronchial Ultrasound to New Endoscopists
Published on: August 11, 2023
Endobronchial ultrasound-guided mediastinal lymph node forceps biopsy in patients with negative
Ravindra M Mehta1, Rohan Aurangabadbadwalla1, Abhinav Singla1
1Department of Pulmonary, Critical Care and Sleep Medicine, Apollo Hospitals, Bangalore, India.
Background:
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) provides a high diagnostic yield in lung cancer, but the yield for benign conditions and lymphoma is lower. The material obtained by EBUS-TBNA is limited by the lack of histopathological samples in some cases. The current 'expanded' aims of mediastinal lymph node (MLN) sampling are both an accurate diagnosis and adequate material for 'targeted' processing in malignant and benign disease. The sample obtained with the 21/22G EBUS needle may not be sufficient in all situations.
Objectives:
The aim of the study was to evaluate the role of a novel technique for EBUS-guided MLN forceps biopsy (EBUS-TBFB) when EBUS-TBNA with rapid on-site-evaluation (ROSE) failed to provide a diagnosis. In addition, the technical aspects and safety of EBUS-TBFB were studied.
Methods:
About 30 consecutive patients with enlarged MLN, with a negative EBUS-TBNA ROSE were included. EBUS-TBFB was done by the method described below. The histopathology and complications were recorded.
Results:
Adequate samples for analysis were obtained in all the patients with both EBUS-TBNA and EBUS-TBFB. In patients with a non-diagnostic EBUS-ROSE, EBUS-TBFB led to positive diagnostic results in an additional 8/30 patients (27%). Mild bleeding was noted in two patients who underwent EBUS-TBFB, which resolved with conservative management. The procedure was safe with no major complications.
Conclusion:
In patients with a negative EBUS-ROSE, EBUS-TBFB using this technique is safe and augments the diagnostic yield. EBUS-TBFB adds to the armamentarium of EBUS, especially in benign aetiologies of MLN enlargement.
