Hilar and mediastinal lymph nodes are frequently involved in both benign and malignant diseases of the chest. Accessing those lymph nodes is helpful diagnostically and is critical in appropriate staging of non-small cell lung cancers. Trans-bronchial needle aspiration (TBNA) has been available for two decades to access lymph nodes adjacent to the airways, but has not been widely adopted because of low sensitivity and because it is difficult and time consuming.
Endobronchial ultrasound (EBUS) guided TBNA is rapidly emerging as the standard method of TBNA. EBUS-TBNA has higher sensitivity, and because the sampling can be done under direct guidance, greater safety and an ability to sample smaller nodes. An EBUS bronchoscope is now available in both the operating rooms and the bronchoscopy suite at Tisch. This will support improved and less invasive diagnosis and staging of non-small cell lung cancers.