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Updated: Jan 28, 2026

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy versus transbronchial needle aspiration for
Mingming Deng1, Fei Tang2, Yifei Chen3
1National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Background And Objectives:
Endobronchial ultrasound (EBUS)-guided transbronchial mediastinal cryobiopsy (TBMC) has potential superiority compared with EBUS-guided transbronchial needle aspiration (TBNA) in the diagnosis of patients with intrathoracic sarcoidosis. However, high-quality clinical evidence is lacking. The aim of this study was to compare the efficacy and safety of EBUS-TBMC and EBUS-TBNA in diagnosing patients with intrathoracic sarcoidosis.
Methods:
A multicenter randomized controlled trial was conducted in patients with suspected stage I/II sarcoidosis. Following identification of the mediastinal lesion via EBUS, TBNA and TBMC were sequentially performed in a randomized order. The granuloma detection rate was the primary outcome. The final diagnosis was based on pathology results and clinical follow-up at 6 months after randomization.
Results:
A total of 128 patients with suspected stage I/II sarcoidosis were recruited for this study. Among them, 116 patients were diagnosed with sarcoidosis at 6 months after randomization. The granuloma detection rate was 89.8% (95% confidence interval [CI], 83.3-94.5) for EBUS-TBMC and 78.1% (95% CI, 70.0-84.9) for EBUS-TBNA, and the difference was significant (P < 0.001). The histological quality of the EBUS-TBMC samples was superior to that of the EBUS-TBNA samples (P < 0.001). Only one case of pneumothorax was detected by chest radiography, which resolved spontaneously without the need for drainage or other interventions.
Conclusions:
Compared with EBUS-TBNA, EBUS-TBMC had superior granuloma detection rate and histological quality of samples with acceptable safety in patients suspected with stage I/II sarcoidosis.
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