Endobronchial ultrasound-guided sampling: diagnostic yield of needle biopsy and cryobiopsy in addition to…

Cohort studyAnnals of the American Thoracic Society· Feb 2026

Endobronchial ultrasound-guided sampling: diagnostic yield of needle biopsy and cryobiopsy in addition to needle aspiration.

Jason Beattie, Hamad Nasim, Jacqueline Chen … Adnan Majid

Surgical PathologyCohort studyDiagnosisQ1IF 3.2

Cryobiopsy diagnosed more mediastinal/hilar nodes than needle aspiration alone.

Endobronchial ultrasound-guided sampling: diagnostic yield of needle biopsy and cryobiopsy in addition to needle aspiration.

Jason Beattie … Adnan Majid

Annals of the American Thoracic Society · Feb 2026

Background

Endobronchial ultrasound (endobronchial ultrasound)-guided sampling for evaluation of benign conditions and lymphoma is not standardized.

Methods

We performed a single-center study with protocolized sampling and processing to evaluate the diagnostic yield of transbronchial needle aspiration (transbronchial needle aspiration), Franseen needle biopsy (transbronchial needle biopsy [TBNB]), and cryobiopsy in patients with mediastinal and hilar abnormality with concern for sarcoid, lymphoma, or undifferentiated lymphadenopathy.

n = 51 patients

Results

Cryobiopsy diagnosed 82% of nodes vs 50% with needle aspiration alone (P=.0001).

50%

TBNA

73%

TBNB

82%

Cryobiopsy

More results

In subgroup analysis, TBNB and cryobiopsy enhanced diagnostic yield in benign conditions (transbronchial needle aspiration [59%], TBNB [88%], and cryobiopsy [100%]; transbronchial needle aspiration vs cryobiopsy, P = .002; transbronchial needle aspiration vs TBNB, P = .01; TBNB vs cryobiopsy, P = .11).

More results

For lymphoma, the diagnostic yield per node was 3/10 for transbronchial needle aspiration, 5/10 for TBNB, and 6/10 for cryobiopsy (transbronchial needle aspiration vs cryobiopsy, P = .001; transbronchial needle aspiration vs TBNB, P = .1; TBNB vs cryobiopsy, P = .1).

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Conclusion · 1 of 2

Both TBNB and cryobiopsy enhance the diagnostic yield of EBUS-transbronchial needle aspiration in benign conditions. Multiple passes with 3 biopsy tools at an individual lymph node is safe and feasible.

Conclusion · 2 of 2

Cryobiopsy provides superior sample quality relative to TBNB and superior yield vs transbronchial needle aspiration in lymphoma.