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Endobronchial ultrasound bronchoscopy with needle biopsy


Medical editor Arve Sundset MD
Lung Specialist

Oslo University Hospital
Norway

General

The location of the tumor or lymph nodes in the mediastinum determines whether an endoscopic ultrasound-guided fine-needle aspiration from the esophagus (EUS), or bronchus (EBUS-TBNA) is performed. EBUS of mediastinal lymph nodes is a minimally invasive procedure which allows the patient to avoid riskier procedures.

Indications

  • Enlarged lymph nodes and/or tumor in the mediastinum
  • To stage lung cancer or to confirm or disprove spread to the lymph nodes of the mediastinum
  • To confirm or disprove suspicion of lung cancer or spread of other cancer in the mediastinum and to confirm the histological type

Goal

  • Make a diagnosis
  • Staging

Equipment

  • Endoscope with accessories
  • Puncture biopsy needle
  • Equipment for preparation of cytological specimen

Preparation

  • The procedure is usually carried out under general anesthesia. In some cases, the procedure is performed with local anesthesia only. 
  • The patient should fast 8 hours before the procedure.

Implementation

  • The bronchoscope is inserted into the airways via an endotracheal tube.
  • The appropriate lymph nodes are visualized by ultrasound.
  • The aspiration needle is inserted through the work channel in the bronchoscope and guided by ultrasound, into the lymph node. 
  • Using back and forth motions with the needle, cells are aspirated from the lymph node.
  • The material is prepared and assessed by a cytologist.
  • The procedure can be repeated until representative material is obtained.

Follow-up

  • The patient may return home the same day.
  • The result from the needle biopsy is usually available after 2-3 days.

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