Transbronchial forceps biopsy of lymph nodes in the diagnosis of mediastinal lymphadenopathy

The recommended methods for obtaining biopsy material for the differential diagnosis of mediastinal lymphadenopathy (ML), such as transbronchial or transesophageal needle biopsy under the control of intraluminal ultrasound (ultrasound transbronchial fine-needle biopsy – US-FNB), require expensive equipment and consumables, while the availability of US-FNB for routine use is currently limited. The aim of the study is to evaluate the safety and efficacy of forceps transbronchial lymph node biopsy (FTLB) as one of the main methods for verifying the etiology of ML. Methods. A study was conducted in 2024 – 2025, which included patients (n = 91) with radiologically confirmed ML. The experience of using an alternative endoscopic approach to diagnosing the causes of ML using widely available equipment is presented. Results. The following diagnoses were confirmed based on the obtained histological material – sarcoidosis of intrathoracic lymph nodes (77 (85%)), cryptococcosis (2 (2%)), squamous cell lung cancer (G2) (1 (1%)), and poorly differentiated lung adenocarcinoma (3 (3%)). The biopsy material was uninformative in 7 (8%) cases. Conclusion. The presented method of PTBL can be used in centers where equipment for ultrasound-FBI is not available or in cases where ultrasound-FBI was ineffective.