{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T06:54:34Z","timestamp":1777359274923,"version":"3.51.4"},"reference-count":24,"publisher":"The Korean Academy of Tuberculosis and Respiratory Diseases","issue":"3","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004776","name":"Faculty of Medicine, Chulalongkorn University","doi-asserted-by":"publisher","award":["66\/038"],"award-info":[{"award-number":["66\/038"]}],"id":[{"id":"10.13039\/501100004776","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-trd.org"],"crossmark-restriction":true},"short-container-title":["Tuberc Respir Dis"],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:p>Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a predominantly used method for lymph node (LN) metastasis assessment. This study aims to identify tissue adequacy improvement with the addition of EBUS-guided miniforcep biopsy (EBUS-MFB) to EBUS-TBNA in sampling LNs.Methods: We assessed tissue adequacy in patients with mediastinal and hilar lymphadenopathy, comparing the combination of EBUS-MFB and EBUS-TBNA with EBUS-TBNA alone. EBUS-MFB was performed with the guide sheath (GS) dilatation technique. Tissue adequacy was a tumor cell count (TCC) of &gt;100 and neoplastic cell neoplastic cell estimate of &gt;25%. Further, we reported the diagnostic yield, tumor cell characteristics, and safety outcomes.Results: Among 69 patients (74 nodes), malignant diseases were diagnosed in 41 nodes using both techniques. Tissue adequacy with EBUS-TBNA (93.8% in 30\/32 nodes) was comparable with the combined group (96.9% in 31\/32 nodes, p=0.317). EBUS-TBNA yielded higher TCC (84.4% with &gt;1,000 cells) than EBUS-MFB (53.1%, p=0.004). The combined approach significantly improved the diagnostic yield in non-malignant diseases compared with EBUS-TBNA alone (97% vs. 78.8%, p=0.014). Of the 32 nodes, 20 demonstrated discordant results between EBUS-TBNA and EBUS-MFB, with EBUS-MFB correctly diagnosing six nodes that EBUS-TBNA misdiagnosed. The complication rate was low (2.9%) with only minor bleeding reported.Conclusion: EBUS-TBNA alone and the combination of EBUS-MFB and EBUS-TBNA demonstrated comparable tissue adequacy, with EBUS-TBNA exhibiting better specimen characteristics, potentially sufficient for various molecular analyses. The addition of EBUS-MFB, performed using the GS-dilatation technique, to EBUS-TBNA improved the diagnostic yield and proved to be a safe and efficient approach, particularly in non-malignant diseases.<\/jats:p>","DOI":"10.4046\/trd.2024.0134","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T23:02:38Z","timestamp":1743721358000},"page":"545-556","update-policy":"https:\/\/doi.org\/10.4046\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle Aspiration"],"prefix":"10.4046","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2709-7071","authenticated-orcid":true,"given":"Pipu","family":"Tavornshevin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poonchavist","family":"Chantranuwatana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vorawut","family":"Thanthitaweewat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virissorn","family":"Wongsrichanalai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thitiwat","family":"Sriprasart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7864-3415","authenticated-orcid":true,"given":"Nophol","family":"Leelayuwatanakul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2481","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.88.6.860"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.4103\/2303-9027.180762"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.03.069"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-011-9341-0"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1159\/000350867"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.08.106"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2019.10.001"},{"key":"ref8","first-page":"301","volume-title":"Minimal 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