Bf uc190f

All patients underwent an EBUS guided bronchoscopic biopsy (BF-UC190F, Olympus, Tokyo, Japan) under general anesthesia with either a laryngeal mask airway or endotracheal tube at the University of California, San Francisco, Medical Center. An Olympus EBUS bronchoscope (BF-UC190F, Olympus, Tokyo, Japan) with a 21 or 22 g needle was used for all biopsies (ViziShot EBUS TBNA Needle, Olympus, Tokyo, Japan). Onsite cytology was present for all biopsies to confirm adequacy of the specimens. Lymph node specimens were considered as positive for benign anthracotic inflammation if one or more lymph nodes in the mediastinum or hilum had an SUV >2.5 and the biopsy specimen showed anthracotic pigment (black pigment) inside histiocytes and macrophages, as interpreted by the attending pathologist (Figure 1).

The prototype TCP-EBUS (BF-Y0086, Olympus Medical Systems Corp., Japan) has a distal outer diameter of 5.9 mm with maximum upward flexion of 170 degrees, whereas the conventional CP-EBUS used in this study (BF-Y0063, Olympus Medical Systems Corp.) has a 6.6-mm tip and 160 degrees maximum upward flexion (Figure 1). The specifications of the conventional CP-EBUS mirror those found in the commercially available BF-UC190F (Olympus Medical Systems Corp.). TCP-EBUS has a 1.7-mm working channel, which can accommodate commercially available 25-gauge EBUS-TBNA needles (NA-U401SX-4025N, Olympus Medical Systems Corp.).

EBUS‐TBNA and EBUS‐IFB were performed under general anesthesia through a laryngeal mask. EBUS‐TBNA was performed with a dedicated linear bronchoscope (BF‐UC190F, Olympus Ltd) and a 19‐G needle (ViziShot Flex 19G needle Olympus Ltd).
We used the lymph node sampling methods described in other studies.⁴, ¹⁴, ¹⁵ For each patient, three passes were performed and each pass included 10 agitations of the needle within the target site. The suction method was used. We did not perform smears but all the samples were gathered in one vial for cell block preparation as detailed below.
Following needle punction, a track for introduction of the miniforceps into the targeted lymph node was created. With the EBUS bronchoscope in a steady position, the needle was withdrawn from the working channel and the miniforceps (CoreDX, Boston Scientific) were advanced into the target under EBUS guidance. Once inside the target lesion, the miniforceps were opened, and biopsy specimens were taken under continuous EBUS surveillance (Figure 1). Three biopsies were performed for each lymph nodes. No rapid on site examination (ROSE) was performed.