Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS
TBNA) is the accepted first test in the pretreatment staging of lung cancer suitable for
curative therapy. Virtually all patients having Surgery or Radical Radiotherapy should
undergo the procedure, with the exception of clinical Stage 1A patients. Even cases
with tumors larger than 3cm (Stage 2 and greater) who have a CT and PET clear
mediastinum should have EBUS TBNA staging. Clinical (CT and PET) negative
mediastinal nodes have an incidence of occult metastatic disease of over 20%.
Technical aspects of EBUS TBNA are becoming standardized given its now over 10
years of use in the clinical setting. Rapid on site examination of EBUS TBNA samples
can be extremely helpful in the performance of staging procedures particularly to allow
curtailment of the procedure once malignant cells are detected.
EBUS TBNA can be used to make the diagnosis of lung cancer especially where the
mass is adjacent a proximal airway. EBUS TBNA material is ideally suited to be used
for genetic analysis of malignant cases and this feature alone ensures EBUS TBNA will
continue to have a central role in the management of lung cancer patients.
Keywords: Bronchoscopy, Endobronchial Ultrasound Guided Transbronchial
Needle Aspiration (EBUS TBNA), Lung cancer, Mediastinal nodes, Occult
metastatic disease, Radical Radiotherapy, Rapid-on-site-evaluation (ROSE).
