Endobronchial ultrasound biopsy (EBUS) is a procedure that is performed by a pulmonologist to obtain tissue samples from the lungs. The procedure is performed by inserting a thin, flexible tube called an endoscope into the lungs. Images of the lungs are then transmitted to a monitor so that the pulmonologist can guide the endoscope to the area of the lung that needs to be sampled. A small sample of tissue is then obtained from the area and sent for analysis.
There are two types of endobronchial biopsy procedures: a transbronchial needle aspiration (TBNA) and a fiberoptic bronchoscopy. In a TBNA, the sample is obtained using a needle inserted through the chest wall under CT or ultrasound guidance. A fiberoptic bronchoscopy is performed using a bronchoscope, which is inserted through the nose or mouth and allows the doctor to see the trachea and mainstem bronchi. A small brush can also be passed down the bronchoscope in order to obtain a sample from the smaller airways of the lung called bronchial brushes or bronchial washing.
Endobronchial ultrasound is an important diagnostic test that can be used to help diagnose conditions such as lung cancer, tuberculosis, pneumonia, and lymphoma. Although the procedure was developed a few decades ago, it has recently become more widely used due to its ability to collect tissue samples from hard-to-reach areas of the lungs. Similar to other types of biopsies, EBUS-TBNA samples lung tissue through the nose or mouth using a bronchoscope and needle.
Before the test, you will be asked to remove any makeup and jewelry. A sedative may be injected through an intravenous (IV) catheter in your hand or arm to help you relax. You may also be given a medication called atropine to reduce secretions within the airways. The atropine can cause side effects such as a dry mouth, blurred vision, and decreased heart rate.
A chest X-ray is performed to determine the position of the endoscope. The chest X-ray will also show how much lung tissue your doctor should sample during the test. Once this is determined, you will be taken to the procedure room where a flexible bronchoscope and other instruments will be inserted through your nose or mouth. The doctor performing the test will look for abnormalities in the lung tissue while directing your attention to what is being seen on a video monitor. You may watch the procedure if you like on a television monitor placed above you.
The entire test usually takes about 20 minutes, but can range from 20 minutes to 2 hours, depending on the extent of sampling needed.
In all of these procedures, the risks include bleeding, infection, or pneumothorax (damage to the lung causing air leakage into the chest). As with most medical procedures there are benefits and risks to consider. It is important for you to discuss these considerations with your pulmonologist so that you can decide if this procedure is right for you.