Comparison of diagnostic yield and safety of endobronchial ultrasound-guided mediastinal lymph nodal cryobiopsy and endobronchial ultrasound-guided Franseen tip needle biopsy

In this prospective study, we evaluated the diagnostic yield and safety of two endobronchial ultrasound (EBUS) biopsy techniques - mediastinal cryobiopsy (EBUS-MCB) and Franseen tip needle biopsy (EBUS-ANB) - in patients with undiagnosed mediastinal lymphadenopathy. The study included 30 patients who underwent both EBUS-MCB and EBUS-ANB, with four biopsies taken from each patient using both methods. The results demonstrated that EBUS-MCB provided a higher diagnostic yield (96.4%) compared to EBUS-ANB (73.3%). Specimens from EBUS-MCB showed fewer artifacts and a higher density of granulomas and were adequate for ancillary studies in all cases. The most common complication observed was minor bleeding, which was more common with EBUS-MCB (36.6% vs. 13.3%, p=0.04). This study demonstrates that EBUS-guided cryobiopsy has a higher diagnostic yield when compared to EBUS-ANB and that both biopsy techniques have an acceptable safety profile. Larger studies comparing these two techniques are necessary to confirm the findings of the current study.