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Review
. 2014 Aug;122(8):561-76.
doi: 10.1002/cncy.21431. Epub 2014 Apr 23.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): an overview and update for the cytopathologist

Paul A VanderLaan  1 , Helen H Wang, Adnan Majid, Erik Folch
Affiliations
Free article
Review

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): an overview and update for the cytopathologist

Paul A VanderLaan et al. Cancer Cytopathol. 2014 Aug.
Free article

Abstract

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a minimally invasive technique for evaluating the mediastinum and staging patients with lung cancer. In the hands of an experienced operator, the procedure is safe and provides excellent sensitivity, specificity, and predictive diagnostic values. In conjunction with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), a nearly complete mediastinal evaluation can be performed in a minimally invasive fashion. This strategy results in improved lymph node staging, markedly reduced need for mediastinoscopy, and fewer futile thoracotomies compared with a traditional surgical staging procedure. The procedure is cost effective and provides excellent cytologic specimens that have proven well suited for ancillary testing, such as immunohistochemistry and tumor genotyping. EBUS-TBNA, initially used as a tool to sample the lymph nodes adjacent to the airway walls, has now become instrumental in sampling lesions in the mediastinum, hilum, and lung parenchyma, where previously more than 1 procedure would have been necessary. Looking forward, expanded use of this procedure is likely to revolutionize the access to cytology-proven staging and restaging of lung cancer and other thoracic malignancies in a minimally invasive fashion.

Keywords: EBUS-TBNA; FNA; cost effectiveness; cytology; endobronchial ultrasound-guided transbronchial needle aspiration; fine-needle aspiration; lung cancer staging; lymph node; sample adequacy.

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