Transbronchial needle aspiration combined with cryobiopsy in the diagnosis of mediastinal diseases: a multicentre, open-label, randomised trial

Thoracic SMARCA4‐deficient undifferentiated tumor diagnosed by transbronchial mediastinal cryobiopsy: A case report

“…The primary technical challenge of EBUS‐cryo is to establish a standard technique for creating a cryoprobe insertion tract into the lymph node. The high success rate of a high‐frequency needle‐knife incision technique has been demonstrated in two large randomized controlled trials 7,9 . In our case, the puncture hole was widened by tunneling with the needle alone using a combination of angulation and rotational maneuvers 11 .…”

“…A recent randomized controlled trial demonstrated the additional diagnostic value of EBUS‐cryo over EBUS‐TBNA. 9 Regarding sample quality and quantity, no studies have compared the diagnostic performance of EBUS‐IFB and EBUS‐cryo; however, EBUS‐cryo may be superior to EBUS‐IFB, as in our case. Furthermore, EBUS‐cryo may also be advantageous in NGS analysis.…”

“…The high success rate of a high-frequency needle-knife incision technique has been demonstrated in two large randomized controlled trials. 7,9 In our case, the puncture hole was widened by tunneling with the needle alone using a combination of angulation and rotational maneuvers. 11 This modified EBUS-IFB technique has also demonstrated a high technical IFB success rate of 90.8% (177/195).…”

“…4,5 Recently, EBUS-guided transbronchial mediastinal cryobiopsy (EBUS-cryo), which can obtain larger high-quality tissue samples with fewer crush artifacts, has demonstrated advantages over EBUS-TBNA in diagnosing uncommon mediastinal tumors. [6][7][8][9][10] However, combined EBUS-cryo and EBUS-guided intranodal forceps biopsy (EBUS-IFB) remain to be reported. 5 Herein, we report a case of SMARCA4-UT successfully diagnosed by adding EBUS-cryo after EBUS-TBNA and EBUS-IFB.…”

“…However, core tissues obtained by EBUS‐TBNA are sometimes inadequate for immunostaining because of tissue volume, blood contamination, and crushing 4,5 . Recently, EBUS‐guided transbronchial mediastinal cryobiopsy (EBUS‐cryo), which can obtain larger high‐quality tissue samples with fewer crush artifacts, has demonstrated advantages over EBUS‐TBNA in diagnosing uncommon mediastinal tumors 6–10 . However, combined EBUS‐cryo and EBUS‐guided intranodal forceps biopsy (EBUS‐IFB) remain to be reported 5 …”