Background: Transbronchial mediastinal cryobiopsy (TBMC) is a safe, effective technique that offers higher diagnostic yield for mediastinal lesions-especially lymphoproliferative and nonneoplastic diseases-compared to endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA).However, real-world data are limited, particularly in Asian populations.Therefore, this study aimed to compare the diagnostic performance and safety of EBUS-TBNA and TBMC.Methods: In this single-center retrospective study in Seoul, Korea, TBMC was used for patients with mediastinal lesions exhibiting imaging features suggestive of non-lung cancer diagnoses, extensive necrosis likely to lower needle-sampling yield, or previous nondiagnostic procedures.Between June 2023 and February 2024, 29 patients underwent TBNA followed by TBMC during EBUS.Results: The mean age was 59.6 years, and 69% were male.TBNA and TBMC were performed 2.82 and 2.55 times per lesion on average, respectively.Twelve patients had nonneoplastic (e.g., sarcoidosis, tuberculosis, immunoglobulin G4-related disease), and 17 had neoplastic (lung cancer, lymphoma, thymoma) diseases.Adequate tissue was obtained in all transbronchial mediastinal cryobiopsy cases, which showed a significantly higher overall diagnostic yield than TBNA (89.7% vs. 58.6%,P = 0.006), particularly in lymphoma (100% vs. 37.5%, P = 0.025), with no significant difference in lung cancer or nonneoplastic diseases.Mild-to-moderate bleeding occurred in two patients (6.8%) per group and was controlled without complications.Conclusion: Transbronchial mediastinal cryobiopsy demonstrated a higher diagnostic yield than EBUS-TBNA-particularly for lymphoma-with a favorable safety profile.
Kim et al. (Thu,) studied this question.
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