title: Endobronchial ultrasound-guided transbronchial needle aspiration.
abstract: 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.
authors.affiliation: North Bristol Lung Centre, Southmead Hospital, Westbury-on-Trym, Bristol, United Kingdom. andrewmedford@hotmail.com
authors.forename: Andrew R L
authors.initials: AR
authors.lastname: Medford
mesh_terms: D044963:Biopsy, Fine-Needle / Q000295:instrumentation / Q000379:methods*; D001980:Bronchi / Q000000981:diagnostic imaging / Q000473:pathology*; D001999:Bronchoscopy / Q000379:methods; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D004867:Equipment Design; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D018084:Ultrasonography, Interventional / Q000379:methods*