Description of Endobronchial Ultrasound-Guided Transbronchial Mediastinal Cryobiopsy for Mediastinal Lesions: A...

Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-TBNC) enables the acquisition of larger and higher-quality tissue samples than conventional endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA); however, evidence regarding its use and outcomes in Latin America remains limited. This retrospective observational study describes the clinical and procedural characteristics, the frequency of diagnosis obtained by histopathology, and the safety of patients subjected to EBUS-TBNC between June 2023 and December 2025. A total of 118 patients were included; 50.4% were female, and the mean age was 59.6 ± 17.8 years. Initial diagnosis was the main procedural indication (82.2%), and 79.7% of procedures targeted mediastinal lymph nodes, with station 7 being the most frequently biopsied (71.2%). A definitive histopathological diagnosis was obtained in 92.4% (109/118) of patients. The most common complications were pneumomediastinum (11.9%), bronchospasm (5.9%), and pneumothorax (4.2%), with no hemomediastinum or infectious complications reported. Lymphoma was the most frequent neoplasm (27.9%), whereas anthracosis was the predominant benign diagnosis (14.4%). Molecular testing was feasible, with PD-L1 (programmed death-ligand 1) being the most frequently assessed biomarker (37.3%). These findings suggest that EBUS-TBNC is a valuable technique for obtaining tissue suitable for comprehensive histopathological and molecular assessment, supporting its use in the diagnostic evaluation of mediastinal lesions. Its safety profile was characterized predominantly by non-severe complications, supporting its potential role as a diagnostic tool for mediastinal lesions, particularly in clinical scenarios where larger tissue samples are required, such as the evaluation of lymphoma.