EBUS guided trans-esophgeal cryobiopsy-two case reports

Endobronchial ultrasound (EBUS) guided mediastinal cryobiopsy is a novel technique which can be combined with EBUS -TBNA to improve the diagnostic yield. Recent studies report, this technique is safe and superior to EBUS TBNA alone in terms of acquisition of larger tissue samples and thereby a better diagnostic yield and adequacy of tissue for molecular studies. However, safety of this technique in patients do not tolerate a bronchoscopic procedure due to hypoxia or respiratory distress is not clarified yet. Alternatively, EBUS guided FNA via trans-esophageal route(EUS-B-FNA) is a proven technique with a similar diagnostic yield as EBUS TBNA with a better tolerance and a more patient comfort. We report two patients here, in whom EUS- B guided cryobiopsy was successfully done via trans-esophageal route, due to intolerance for bronchoscopic procedure and inconclusive ROSE reports.