Endobronchial ultrasound transbronchial needle aspiration: A hybrid method

Background: Conventional transbronchial needle aspiration (cTBNA) was first performed approximately 30 years ago; however TBNA was not widely adopted until the development of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA). Current EBUS-TBNA needle sizes are limited to 21- and 22-gauge. In order to determine whether a 19-gauge (19G) needle in EBUS-TBNA can further improve the diagnostic yield and simplify the methodology of EBUS-TBNA we developed a hybrid method. Here we report our initial experience in assessing the feasibility of performing EBUS-TBNA using a conventional 19G TBNA needle. Methods: Ten patients with diagnosed or suspected lung cancer with or without lymphadenopathy (LAD) were sampled for diagnostic and/or staging purposes. Patients with suspected benign processes were sampled only for diagnosis. A 19G cTBNA needle was deployed through the working channel of the EBUS bronchoscope. Samples obtained were evaluated for cyto- and histopathologic adequacy. Results: All 10 patients successfully underwent hybrid 19G EBUS-TBNA. All samples were considered adequate for cyto- and histopathologic evaluation. Conclusions: Hybrid EBUS-TBNA utilizing a 19G cTBNA needle through an EBUS scope is feasible and may be able to reliably acquire histologic specimens.