Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration remains the gold standard for the diagnosis of mediastinal pathologies. Its greatest limitation has been the low diagnostic yield in lymphoproliferative disorders as well as insufficient samples for molecular testing. Transesophageal examinations using an EBUS scope have helped increase the diagnostic yield by allowing for additional biopsies of paraesophageal and intra-abdominal lesions. Similarly, the novel approach of transbronchial mediastinal cryobiopsy has further increased the yield by providing larger and better-preserved biopsies. Both complimentary techniques have shown great individual feasibility and safety. However, the feasibility of transesophageal cryobiopsies in the evaluation of mediastinal pathologies remains a subject of debate. Aim: The aim of the study was to investigate the safety and feasibility of transesophageal EBUS-guided mediastinal cryobiopsies performed at our center. Methods: We conducted a retrospective review of 30 patients who underwent mediastinal cryobiopsy through the esophagus at our institution between October 2023 and March 2024. Data on patient demographics, diagnostic yield, and complications were collected and analyzed. Results: The mean patient age was 43 years, with a gender distribution of 60% male and 40% female. The primary indications included suspicion of lymphoproliferative disorders, suspected sarcoidosis, and malignancies with paraesophageal lesions. The overall diagnostic yield was 93%. No major complications were noted in any of the patients. Conclusion: Transesophageal mediastinal cryobiopsy appears to be a promising complimentary technique for mediastinal evaluation with a relatively high diagnostic yield and favorable safety profile. However, further studies with larger cohorts are warranted to validate the findings at our institution.

1.
Zhang
J
,
Guo
JR
,
Huang
ZS
,
Fu
WL
,
Wu
XL
,
Wu
N
, et al
.
Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: a randomised trial
.
Eur Respir J
.
2021
;
58
(
6
):
2100055
.
2.
Ariza-Prota
M
,
Pérez-Pallarés
J
,
Fernández-Fernández
A
,
García-Alfonso
L
,
Cascón
JA
,
Torres-Rivas
H
, et al
.
Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: safety, feasibility and diagnostic yield - experience in 50 cases
.
ERJ Open Res
.
2023
;
9
(
2
):
00448-2022
2022
.
3.
Poletti
V
,
Petrarulo
S
,
Piciucchi
S
,
Dubini
A
,
De Grauw
AJ
,
Sultani
F
, et al
.
EBUS-guided cryobiopsy in the diagnosis of thoracic disorders
.
Pulmonology
.
2024
.
4.
Zhang
J
,
Fu
W-L
,
Huang
Z-S
,
Guo
J-R
,
Li
Q
,
Herth
FJF
, et al
.
Primary mediastinal seminoma achieved by transbronchial mediastinal cryobiopsy
.
Respiration
.
2020
;
99
(
5
):
426
30
.
5.
Nakashima
K
,
Umeda
Y
,
Demura
Y
,
Takeda
T
,
Tada
T
,
Sato
M
, et al
.
Safety and utility of Endoscopic Ultrasound with Bronchoscope-guided Fine Needle Aspiration (EUS-B-FNA) in suspected lung cancer patients with poor respiratory or general conditions: a prospective three-center observational study
.
BMC Pulm Med
.
2023
;
23
(
1
):
206
.
6.
Moretti
A
,
Kovacevic
B
,
Vilmann
P
,
Annema
JT
,
Korevaar
DA
.
Performance of EUS-FNA and EUS-B-FNA for the diagnosis of left adrenal glands metastases in patients with lung cancer: a systematic review and meta-analysis
.
Lung Cancer
.
2023
;
186
:
107391
.
7.
Ariza-Prota
MA
,
de Santis
M
,
López-González
F
.
Successful diagnostic mediastinal cryobiopsy by transesophageal endoscopy without using the needle knife
.
Arch Bronconeumol
.
2023
;
59
(
9
):
601
2
.
8.
Huang
Z-S
,
Zhou
D
,
Zhang
J
,
Fu
W-L
,
Wang
J
,
Wu
X-L
, et al
.
Mediastinal nodular lymphocyte predominant hodgkin lymphoma achieved by endoscopic transesophageal cryobiopsy
.
Respiration
.
2022
;
101
(
2
):
190
4
.
9.
Ariza-Prota
MA
,
Pérez-Pallarés
J
,
Fernández-Fernández
A
,
López-González
F
,
Cascón
JA
,
García-Alfonso
L
, et al
.
Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lymph nodes: a case series - how to do it
.
Arch Bronconeumol
.
2022
;
58
(
10
):
718
21
.
10.
Ariza Prota
MA
,
Pérez Pallarés
J
,
Barisione
E
,
Onyancha
S
,
Corcione
N
,
Torres Rivas
HE
, et al
.
Proposal for a standardized methodology for performing endobronchial ultrasound-guided mediastinal cryobiopsy: a four-step approach
.
Mediastinum
.
2024
;
8
:
30
.
You do not currently have access to this content.