[Ultrasound, bronchoscopy].

Endobronchial ultrasonography (EBUS) can be performed using either the balloon or direct contact method. We established that EBUS using 20 MHz probe shows 5 layers of the cartilaginous portion of extrapulmonary bronchus and intrapulmonary bronchus, and 3 layers of the membranous portion. EBUS for peripheral pulmonary lesions has 2 main impacts in bronchoscopic diagnosis. One impact is to analyze the internal structures of peripheral pulmonary lesions, and another impact is to detect the location of peripheral pulmonary lesions during bronchoscopy. EBUS using a guide sheath (EBUS-GS) provides the pathway to peripheral pulmonary lesions. One advantage of EBUS-GS lies in the repeatability of access to the bronchial lesion for sampling. Another advantage of EBUS-GS lies in its ability to protect against bleeding into proximal bronchus from the biopsy site. The final advantage of EBUS-GS is the ability to obtain short-axis bronchial views of peripheral pulmonary lesions. For the successful EBUS-trans-bronchial needle aspiration (TBNA), there are some knacks. One knack is not to puncture the bronchial cartilage by the needle. For getting adequate specimens, the stylet is important part of the needle. After the needle is removed from the bronchoscope, the stylet is inserted into the needle once again to push out the specimens on the filter paper.