Usefulness of endobronchial ultrasound-guided transbronchial cryobiopsy in the diagnosis of inflammatory diseases

Introduction: Endobronchial ultrasound-guided transbronchial cryobiopsy (CRYO-EBUS) is considered an increasingly widespread technique for diagnosing various lung diseases due to its ability to obtain larger, higher-quality samples by preserving the architecture of the biopsied tissue. Aims: Our objective with this study is to analyze the result of cryobiopsies performed in our unit in diagnosing inflammatory lung diseases compared to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Methods: We conducted a descriptive study including 33 patients referred to our Interventional Pulmonology Unit after finding pathological lymphadenopathy on chest computed tomography for CRYO-EBUS and EBUS-TBNA in a single procedure. To do this, we collected general data, including the type of sedation used, the number and size of samples taken, the location of the lymphadenopathy, pathological results, and the concordance between the two techniques and complications. Results: Of the 33 patients (mean age of 54.6±12.9 years), 52% were men. The procedure was performed with midazolam and fentanyl in 55% of cases, under general anesthesia in 29%, and sedation with midazolam and ketamine in 16%. The lymph nodes sampled were 23 subcarinal, 5 left hilar, 3 right hilar, and 2 right paratracheal. The mean number of punctures was 2.23±1.48 with a mean size of 0.19±0.14 cm. A mean of 3.27±1.2 cryobiopsies were subsequently performed with a mean size of 0.41±0.1 cm, although it was not possible to perform one on one occasion. In 93.54% of cases, the TopGain needle was the most frequently used. The pathological results are shown in [ Fig. 1 ]. 83% of patients experienced no complications, with desaturation being the most common complication in two patients, followed by tachycardia, grade I bleeding, and hypertensive crisis. Conclusions: Transbronchial endobronchial ultrasound-guided cryobiopsy (CRYO-EBUS) is a promising technique, providing higher-quality samples for pathological examination and better identification of lesions. The yield of samples obtained by CRYO-EBUS is higher than those obtained by EBUS-TBNA. It is a safe procedure with few minor complications, such as desaturation or tachycardia. Fig. 1 Publication History Article published online: 04 March 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany