Ultrasound-guided Cryobiopsy of Mediastinal/Hilar Lymph Nodes

Summary

EBUS-guided cryobiopsy of mediastinal and hilar lymph nodes has shown to be a useful diagnostic tool to obtain tissue for histological analysis and further targeted therapies in lung malignancies. Due to the large size and better quality of the tissue samples, a higher diagnostic yield than with transbronchial needle aspiration (TBNA) can be expected, especially in non-solid tumors. In previous studies different biopsy protocols were used. The freezing time of cryoprobe (which defines the sample sizes) ranged from 3 to 7 s and the number of biopsies was between 1 and 4 samples. It is therefore unclear what freezing times and biopsy frequency are required to obtain the best histological information.

Eligibility

Inclusion Criteria:

* At least one mediastinal lesion or hilar 1 cm or longer in the short axis requiring diagnostic bronchoscopy
* Age between 18 and 90 years
* Written informed consent after participant's information

Exclusion Criteria:

* Age \< 18 and \> 90 years
* Lacking ability to form an informed consent (including impaired judgement, communication barriers)
* Contraindication against bronchoscopy (e.g. co-morbidities)
* Mediastinal abscess or cyst
* Extraordinary blood supply of the lesion visualized by EBUS bronchoscope
* INR \> 1.5 or Thrombocytes \< 100 G/l
* Clopidogrel or other new antiplatelet drugs within 7 days before biopsy (salicylic acid alone allowed)
* Anticoagulation with NOAC within 48 hours before biopsy
* Pulmonary lesions suspicious of lung carcinoma

Conditions3

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