DOI: 10.1177/17534666261483936 ISSN: 1753-4666

Leftover aspirated material in the EBUS-TBNA suction syringe improves diagnostic yield: A prospective study

Hadas Gilboa-Sagy, David Shitrit, Elad Guber, Andy Eyre, Gali Epstein Shochet, Ayal Romem
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Background

During endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), visible aspirated material may accumulate in the suction syringe but is typically discarded.

Objective

To assess whether cytological examination of suction-syringe aspirate improves the diagnostic performance of EBUS-TBNA.

Design

Prospective, single-center, paired-sample diagnostic study.

Methods

Pooled aspirated material was preserved in formalin and analyzed cytologically alongside routine EBUS-TBNA specimens. Diagnostic yield, adequacy, and accuracy were compared with/without syringe aspirate analysis.

Results

Among 355 screened patients, 151 (42.5%) had visible syringe aspirate and were included. Adding syringe aspirate increased diagnostic yield from 58.3% to 62.9% (+4.6%, p =0.016). Sample adequacy remained unchanged (98.7%). Accuracy for excluding malignancy improved from 85.4% to 88.1%, although not significantly (p=0.125). Concordance between TBNA and syringe samples was 87.9%. Seven diagnoses, including four malignancies, were established exclusively from syringe aspirate.

Conclusion

Cytological analysis of suction-syringe aspirate modestly but significantly enhances EBUS-TBNA diagnostic yield and should be considered in routine practice.

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