EBUS-TBNA: An opportunity for clinicians, cytopathologists and patients to gain from multidisciplinary collaboration

摘要

We launch the 2010 volume of Cytopathology with a series of articles on endoscopic ultrasound (EUS) guided fine needle aspiration cytology (FNAC), 'blind' transbronchial needle aspiration (TBNA) and, as the main topic for this issue, endobronchial ultrasound-guided FNAC (EBUS-FNA). Several of these papers are from the USA, giving us the chance to compare clinical practice, opportunities and challenges in this field on both sides of the Atlantic. Cameron et al. lead their excellent review article with a extensively referenced comprehensive historical review of the development of these endoscopic FNAC techniques, followed by a highly practical guide and illustrated presentation of their experience with EBUS-TBNA. Here we see FNAC evolving as a viable alternative to the more hazardous surgical procedures of mediasti-noscopy and mediastinotomy for the pathological evaluation of mediastinal lymphadenopathy and masses, and are reminded that laboratory costs of these procedures should not be seen in isolation but balanced against the full clinical and financial costs of managing patients, particularly those with potentially operable non-small cell carcinoma (NSCLC) in whom accurate staging is central to appropriate management.