Endobronchial Ultrasound (EBUS): Lung Biopsy and Cancer Staging
Updated: 2 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer
Endobronchial ultrasound (EBUS) is a type of bronchoscopy in which a thin, lighted tube with an ultrasound probe is passed through the mouth or nose into the airways. It shows lymph nodes and masses in the chest, and a needle can take biopsy samples. It's used to diagnose and stage lung cancer. You go home the same day.
What the research says
EBUS biopsy is highly accurate for lung cancer staging: a meta-analysis of 11 studies with 1,299 patients found EBUS-guided needle biopsy had a sensitivity of 93% and specificity of 100% for detecting lung cancer spread to chest lymph nodes, with complications in only 0.15% (Gu P et al., Eur J Cancer, 2009) [2]
Starting with EBUS improves staging: in a randomized trial of 241 people with lung cancer, staging with endosonography followed by surgical staging when needed found lymph node spread with 94% sensitivity versus 79% for surgical staging alone, and cut unnecessary chest operations from 18% to 7% (Annema JT et al., JAMA, 2010) [3]
Key takeaways
A bronchoscopy with an ultrasound probe to see beyond the airway walls.
Allows needle biopsy of chest lymph nodes and masses.
Key for diagnosing and staging lung cancer.
Done under sedation; takes 30–90 minutes.
Same-day procedure with no incision.
Why is it done?
EBUS looks beyond the airway walls.
To look more closely at something seen on a chest X-ray, CT scan or PET scan.
To diagnose and stage lung cancer, including non-small cell lung cancer, and cancers in the mediastinum.
To evaluate lung nodules and enlarged lymph nodes.
To diagnose sarcoidosis, silicosis and other inflammatory lung conditions.
To find lung infections, abscesses and airway narrowing. Sources: [1]
Types of EBUS
EBUS-TBNA uses the convex probe to sample lymph nodes.
Type | What it does |
Convex probe EBUS (CP-EBUS) | Used in the large airways; allows needle biopsy during the procedure |
EBUS-TBNA | A needle passed through a convex probe to sample lymph nodes or masses |
Radial probe EBUS (RP-EBUS) | Gives a 360-degree view and reaches deeper into the lungs; biopsy needs separate tools |
Sources: [1]
EBUS is often used instead of, or before, mediastinoscopy, which requires a small neck incision. Sources: [1, 3]
How do I prepare?
You may need blood tests beforehand.
Don't eat or drink for the time your team specifies.
Tell your provider about all medicines and supplements; you may need to stop some, such as blood thinners.
Arrange a ride home, since you can't drive after sedation. Sources: [1]
What happens during EBUS?
EBUS usually takes 30 to 90 minutes.
An IV is placed and you receive moderate sedation or general anesthesia; your mouth or nose and throat are numbed.
A pulmonologist passes the bronchoscope through your mouth or nose into your airways.
The ultrasound probe shows lymph nodes and tissue beyond the airway walls.
Biopsy samples are taken with a needle if needed.
The scope is removed. Sources: [1]
The procedure takes about 30–90 minutes, and you usually go home within one to two hours. Sources: [1]
Recovery and risks
For about a day you may have a sore throat, hoarseness or cough. Coughing up a small amount of blood is normal and should clear within hours or days. EBUS is very low risk; rare complications include bleeding, infection, a collapsed lung (pneumothorax) and breathing problems. Seek care right away for fever, chest pain, trouble breathing or swallowing, or ongoing coughing up of blood. Sources: [1, 2]
Understanding your results
Samples may be tested for cancer, infection and other conditions. Your provider will explain the results, including whether cancer has spread to lymph nodes, which helps determine staging and treatment. Sources: [1, 2, 3]
Conclusion
EBUS lets doctors see and sample tissue around the airways without surgery. It's now a cornerstone of lung cancer staging and a key test for unexplained chest lymph nodes.
Keep learning: read about lung cancer and bronchoscopy.
Frequently asked questions
What is EBUS?
A bronchoscopy with an ultrasound probe to see beyond the airways.
What is EBUS-TBNA?
A needle biopsy of lymph nodes or masses taken during EBUS.
Why is it done?
To diagnose and stage lung cancer and check chest lymph nodes.
Will I be awake?
You'll have sedation or general anesthesia.
How long does it take?
About 30–90 minutes.
Can I go home the same day?
Usually, within one to two hours.
Is it painful?
No; you may have a sore throat afterward.
What are the risks?
Rare bleeding, infection, collapsed lung or breathing problems.
Can I drive afterward?
No. Arrange a ride home.
How is EBUS different from mediastinoscopy?
EBUS needs no incision; mediastinoscopy uses a small cut in the neck.
Related Reading
Bronchoscopy: Why It's Done, What to Expect, Recovery and Risks the scope procedure EBUS is based on.
Lung Cancer: Symptoms, Causes, Diagnosis, and Treatment Explained the main cancer EBUS helps stage.
Mediastinoscopy: Why It's Done, Procedure, Recovery and Risks a surgical alternative for lymph node sampling.
Sarcoidosis: Complete Guide to the Condition That Forms Granulomas Throughout the Body an inflammatory disease EBUS can diagnose.
Lymph Node Biopsy: Types, What to Expect, Recovery and Results how lymph nodes are sampled.
References
Cleveland Clinic. Endobronchial Ultrasound (EBUS): Purpose, Risks & Results. Cleveland Clinic. Last updated July 17, 2023. https://my.clevelandclinic.org/health/diagnostics/25140-endobronchial-ultrasound-ebus
Gu P, Zhao YZ, Jiang LY, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer. 2009;45(8):1389-1396. PMID 19124238. https://doi.org/10.1016/j.ejca.2008.11.043
Annema JT, van Meerbeeck JP, Rintoul RC, et al. Mediastinoscopy vs endosonography for mediastinal nodal staging of lung cancer: a randomized trial. JAMA. 2010;304(20):2245-2252. PMID 21098770. https://doi.org/10.1001/jama.2010.1705
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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