Endobronchial ultrasound‑guided transbronchial needle aspiration

Endobronchial ultrasound‑guided transbronchial needle aspiration (EBUS‑TBNA) is an advance in bronchoscopy. It is a staging tool for nonsmall cell lung cancer (NSCLC) but also allows diagnosis of unexplained mediastinal lymphadenopathy due to malignant and benign disease. It is a minimally invasive procedure that is used to stage suspected NSCLC with hilar nodes, discrete N2 or N3 disease, or bulky mediastinal disease. After a negative EBUS‑TBNA result, if the pretest probability of lung cancer is high, a mediastinoscopy is still recommended, although in the light of recent trial data this is likely to change. EBUS‑TBNA is expensive, which may limit its development in resource‑rationed health care systems. Conventional (without ultrasound) transbronchial needle aspiration (TBNA) still has a useful role in lung cancer staging, especially where EBUS‑TBNA is not available; it can help avoid unnecessary mediastinoscopies.