EBUS-guided transbronchial biopsy (EBUS-TBNB) with a transbronchial needle forceps (TBNF) – a pilot study

Background:

One limitation of EBUS TBNA is the size of the available needles, yielding frequently only cells for cytological examination. The aim of this pilot study is to evaluate the efficacy and safety of a newly developed forceps-needle to obtain tissue for the histological diagnosis of enlarged mediastinal lymph nodes.

Methods:

Patients with enlarged, PET positive lymph nodes were included. The transbronchial needle-forceps, a sampling instrument combing the characteristics of a needle (beveled tip for penetrating through the bronchial wall) with a forceps (two serrated jaws for grasping tissue) was used through the working channel of the EBUS-TBNA scope.

Results:

50 patients (36M, 19 F; mean age: 51yrs) were included in this pilot study. EBUS TBNF provided tissue for histological diagnosis in 45 patients (90%). In three patients TBNF provides only cytological material, in seven patient's inadequate material. In 48 patients (96%) penetration of the bronchial wall was possible. For patients in whom the material was adequate for a histological examination a specific diagnosis was established in 96% (43 of 45) patients (NSCLC 24, SCLC 7, sarcoidosis 4, Hodgkin Lymphoma 4, tuberculosis 2, NHL 2).

No clinically significant procedure-related complications were encountered.

Conclusions:

This study demonstrates that EBUS- TBNF is a safe procedure and provides diagnostic histological specimens of mediastinal lymph nodes in a large percentage of cases.