title: Endobronchial ultrasound transbronchial needle aspiration: a hybrid method.
abstract: BACKGROUND
  Conventional transbronchial needle aspiration (cTBNA) was first performed approximately 30 years ago; however TBNA was not widely adopted until the development of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA). Current EBUS-TBNA needle sizes are limited to 21- and 22-gauge. In order to determine whether a 19-gauge (19G) needle in EBUS-TBNA can further improve the diagnostic yield and simplify the methodology of EBUS-TBNA we developed a hybrid method. Here we report our initial experience in assessing the feasibility of performing EBUS-TBNA using a conventional 19G TBNA needle.
  
  
  METHODS
  Ten patients with diagnosed or suspected lung cancer with or without lymphadenopathy (LAD) were sampled for diagnostic and/or staging purposes. Patients with suspected benign processes were sampled only for diagnosis. A 19G cTBNA needle was deployed through the working channel of the EBUS bronchoscope. Samples obtained were evaluated for cyto- and histopathologic adequacy.
  
  
  RESULTS
  All 10 patients successfully underwent hybrid 19G EBUS-TBNA. All samples were considered adequate for cyto- and histopathologic evaluation.
  
  
  CONCLUSIONS
  Hybrid EBUS-TBNA utilizing a 19G cTBNA needle through an EBUS scope is feasible and may be able to reliably acquire histologic specimens.
authors.affiliation: 1 Department of Respiratory Medicine, Shanghai Generai Hospital, Shanghai Jiao Tong University, Shanghai 200080, China ; 2 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, University of North Carolina in Chapel Hill, Chapel Hill, NC, USA ; 3 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, the Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Suqin
authors.initials: S
authors.lastname: Ben
authors.affiliation: 1 Department of Respiratory Medicine, Shanghai Generai Hospital, Shanghai Jiao Tong University, Shanghai 200080, China ; 2 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, University of North Carolina in Chapel Hill, Chapel Hill, NC, USA ; 3 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, the Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Akulian
authors.affiliation: 1 Department of Respiratory Medicine, Shanghai Generai Hospital, Shanghai Jiao Tong University, Shanghai 200080, China ; 2 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, University of North Carolina in Chapel Hill, Chapel Hill, NC, USA ; 3 Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, the Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Ko-Pen
authors.initials: KP
authors.lastname: Wang
keywords: 19-gauge needle; EBUS; TBNA; cytology; histology