Related Experiment Video
Updated: Jun 13, 2026
Systematic Endobronchial Ultrasound - The Six Landmarks Approach
Published on: August 11, 2023
Challenging uniform size criteria for EBUS-TBNA sampling: Comparative analysis by lymph node station
Zachary B Strumpf1, Sanjay Balijepalli2, Pavel Galchenko2
1Division of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA; School of Medicine, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA.
Purpose:
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is essential for mediastinal staging in non-small cell lung cancer (NSCLC), yet uniform lymph node (LN) size criteria for sampling remain unvalidated.
Methods:
This single-center retrospective study evaluated consecutive patients who underwent EBUS-TBNA for initial staging of NSCLC with available PET-CT were included. Nonparametric tests compared LN sizes across mediastinal stations 4R, 4L, and 7.
Results:
Among 205 patients (median age 69 years), 1306 LNs were analyzed, including 770 nodes ≥5 mm and 449 mediastinal LNs. Significant size variation was observed across stations in benign nodes (p < 0.001), particularly between 4R or 4L versus 7, while malignant nodes did not differ significantly (p = 0.065).
Conclusions:
These findings suggest that uniform LN size cutoffs for EBUS-TBNA may not be optimal across mediastinal stations. Prospective, multicenter validation is warranted to refine evidence-based criteria for EBUS-guided mediastinal staging.
