EBUS-guided cryobiopsy in the diagnosis of thoracic disorders

V Poletti; S Petrarulo; S Piciucchi; A Dubini; A J De Grauw; F Sultani; S Martinello; H K Gonunguntla; C Ravaglia

doi:10.1016/j.pulmoe.2023.11.008

EBUS-guided cryobiopsy in the diagnosis of thoracic disorders

Pulmonology. 2024 Jan 4:S2531-0437(23)00223-4. doi: 10.1016/j.pulmoe.2023.11.008. Online ahead of print.

Authors

V Poletti¹, S Petrarulo², S Piciucchi³, A Dubini⁴, A J De Grauw², F Sultani², S Martinello², H K Gonunguntla⁵, C Ravaglia⁶

Affiliations

¹ Department of Medical Specialities-Pulmonology, GB Morgagni Hospital, Bologna University-Forlì-Ravenna Campus, Forlì, Italy; Department of Medical and Surgical Sciences (DIMEC), Bologna University, Bologna, Italy; Department of Respiratory Diseases & Allergy, Aarhus University, Aarhus, Denmark. Electronic address: venerino.poletti@gmail.com.
² Department of Medical Specialities-Pulmonology, GB Morgagni Hospital, Bologna University-Forlì-Ravenna Campus, Forlì, Italy.
³ Department of Radiology, GB Morgagni Hospital, Forlì, Italy.
⁴ Department of Pathology, GB Morgagni - L.Pierantoni Hospital Forlì Italy.
⁵ Division of Interventional Pulmonology, Yashoda Hospitals, Hyderabad, India.
⁶ Department of Medical Specialities-Pulmonology, GB Morgagni Hospital, Bologna University-Forlì-Ravenna Campus, Forlì, Italy; Department of Medical and Surgical Sciences (DIMEC), Bologna University, Bologna, Italy.

PMID: 38182468
DOI: 10.1016/j.pulmoe.2023.11.008

Abstract

Background: Endobronchial Ultrasound (EBUS) has emerged as a crucial tool for diagnosing intrathoracic disorders, particularly in the staging of lung cancer. However, its diagnostic capabilities in the context of benign and rare diseases remain a subject of debate.

Aim: to investigate the diagnostic yield and safety of EBUS-transbronchial mediastinal cryobiopsy (EBUS-TMC) in comparison to EBUS-transbronchial needle aspiration (TBNA) for a broad spectrum of intrathoracic diseases.

Methods: a single-centre retrospective observational study conducted on 48 patients who underwent both EBUS-TBNA and endobronchial ultrasound-transbronchial mediastinal cryobiopsy (EBUS-TMC) in the same procedure between August 2021 and October 2023.

Results: The overall diagnostic yield of EBUS-TMC surpassed that of EBUS-TBNA (95.8% vs 54.1 %), notably excelling in the diagnosis of sarcoidosis (92.8% vs 78.5 %), rare mediastinal disorders (100% vs 0 %), hyperplastic lymphadenopathy (100% vs 0 %), and lymphoproliferative disease (100% vs 0 %). No significant differences were observed in the diagnosis of NSCLC and SCLC. Samples obtained through EBUS-TMC facilitated the acquisition of NGS and immunohistochemical analyses more readily.

Conclusion: EBUS-TMC may contribute to the precise diagnosis and subtyping of mediastinal diseases, especially lymphomas and rare mediastinal tumors, thereby reducing the number of non-diagnostic procedures.

Keywords: EBUS-TBNA; EBUS-guided cryobiopsy; Endobronchial ultrasound; Mediastinal cryobiopsy; Mediastinal tumors.