Evaluation of 19-gauge vs 21-gauge EBUS TBNA in Assessing Thoracic Lymphadenopathy

Endobronchial ultrasound-guided transbronchial needle aspirate (EBUS-TBNA) is a technique
used to take samples of body tissue inside the chest without having to undergo an operation.

During this procedure, a special telescope (called a bronchoscope) is inserted through the
mouth into the airways. Ultrasound technology allows the doctor to see the structures just
outside the airway. By being able to see the structures outside the airway, the doctor is
able to safely pass a fine needle through the airway to take samples of abnormal tissue.

EBUS-TBNA is used to take samples of tissue from the mediastinum. The mediastinum is the part
of the chest between the lungs, and contains the heart, gullet, windpipe and lymph nodes.
This area of the body is usually difficult to access without open surgery, hence the use of
EBUS-TBNA. EBUS-TBNA may be used to investigate enlarged lymph nodes. This may be due to
tuberculosis, sarcoidosis or cancer.

Currently, smaller 21-gauge and larger 19-gauge needles are used during the EBUS-TBNA
procedure at Regions Hospital. The purpose of this study is to find out which needle is
better in finding the explanation for the enlarged lymph nodes, and any follow up procedures
that may be necessary if the investigators are unable to get enough tissue during the
EBUS-TBNA procedure (surgical sampling, radiological sampling, and/or follow-up imaging).

Inclusion Criteria:

- Age 18 years or older

- Able to provide informed consent

- Referred for EBUS TBNA sampling at Regions Hospital

Exclusion Criteria:

- On therapeutic warfarin, Plavix, or ticagrelor in the past 5 days

- INR>1.8 or platelets <50K