Endoscopic and endobronchial ultrasound real-time fine-needle aspiration for staging of the mediastinum in lung cancer.

Mediastinal lymph node metastases in patients with non-small cell lung cancer are a critical determinant of operability. Mediastinoscopy is invasive, requires general anesthesia, and carries appreciable morbidity. The development of minimally invasive techniques for the pathologic staging of lung cancer is important. We report a one-stop minimally invasive method for the pathologic diagnosis and staging of the majority of the mediastinum under conscious sedation using a novel prototype endobronchial ultrasound probe with a real-time fine-needle aspiration (FNA) facility in combination with conventional endoscopic ultrasound FNA.