title: How I do it--optimal methodology for multidirectional analysis of endobronchial ultrasound-guided transbronchial needle aspiration samples.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality with a high diagnostic yield for mediastinal lymph node staging of patients with lung cancer. Although limited to the use of needle aspiration during EBUS-TBNA, aspirates has been shown to be useful for molecular analysis. However, the ideal methodology of the specimen handling during EBUS-TBNA has not been described.
  
  
  METHODS
  Based on our institutional experience and review of the literature, we describe the optimal methodology for multidirectional analysis of EBUS-TBNA samples.
  
  
  RESULTS
  EBUS-TBNA specimens can be used for molecular analysis such as epidermal growth factor receptor (EGFR), Anaplastic lymphoma kinase (ALK) and V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations when processed properly. Rapid on-site cytology is invaluable during the assessment of the aspirated during EBUS-TBNA.
  
  
  CONCLUSIONS
  Obtaining adequate samples through a non-surgical biopsy technique for pathologic diagnosis as well as molecular analysis will be of immediate importance for personalized management of lung cancer. EBUS-TBNA is an ideal approach that allows combined pathological and molecular analysis of metastatic lymph nodes.
authors.affiliation: Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakajima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yasufuku
mesh_terms: D044963:Biopsy, Fine-Needle; D001980:Bronchi / Q000000981:diagnostic imaging* / Q000473:pathology*; D019160:Endosonography / Q000379:methods*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*