B80-4-45 Diagnostic Yield Of Ebus Cryobiopsy Vs Tbna In Suspected Lymphoproliferative Disorders: A Prospective Multicenter Study

Rationale

The diagnosis of mediastinal lymphoproliferative disorders (LPDs) is often challenging and requires histopathological assessment from large tissue samples. As a result, new diagnostic techniques have been introduced alongside the commonly used endobronchial ultrasound-guided trans-bronchial needle aspiration (EBUS-TBNA). Among them, EBUS-guided cryobiopsy (EBUS-cryo) has shown promising potential, although high-quality evidence remains limited. Aim of this study was to assess the diagnostic yield of EBUS-cryo compared with EBUS-TBNA in patients with suspected mediastinal LPDs.

Methods

This prospective multicenter study enrolled patients with suspected mediastinal LPDs undergoing bronchoscopy with EBUS for mediastinal lymph node sampling. All participants had either B symptoms or a history of LPD. All patients underwent EBUS-TBNA followed by EBUS-cryo from the same mediastinal lymph node. Final diagnoses were confirmed after a 6-month follow-up.

Results

Fifty-eight patients underwent EBUS, with 50 (mean age 61; 52% female) completing both procedures and included in the analysis. The most frequent diagnoses were LPDs (27 cases, 54%) and sarcoidosis (15 cases, 30%). EBUS-TBNA yielded diagnostic samples in 60% of the cases, while EBUS-cryo achieved 88%. Among non-diagnostic samples by EBUS-TBNA, 80% were diagnostic with EBUS-cryo (odds ratio 4.89, 95% CI 1.76-13.6). For confirmed LPDs, diagnostic yield was 41% for EBUS-TBNA and 85% for EBUS-cryo. No major complications during or following the procedure were observed with EBUS-cryo.

Conclusion

EBUS-cryo was superior to EBUS-TBNA and achieved a high diagnostic yield in patients suspected of having mediastinal LPDs.

This abstract is funded by: none