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Lymph nodes are little bean-shaped organs in the body that filter out toxins such as infection and cancer. There are lymph nodes located all through the body; in particular, there are lymph nodes surrounding the lungs, trachea and bronchi (airway).

Lung cancer often goes through the lymph nodes when it begins to spread outside the lungs. When someone has an enlarged lesion or lymph nodes in the mediastinum (the space between the lungs that contains the heart, esophagus and airway), surgeons are able to biopsy these lesions through the airway using a procedure called endobronchial ultrasound (EBUS).

Properly assessing the lung's surrounding lymph nodes is fundamental in diagnosing and treating lung cancer. If lung cancer has spread to the lymph nodes, a new treatment plan may be recommended.

At Dignity Health, we frequently use EBUS to biopsy lymph nodes and lesions in the mediastinum. During this procedure, the patient is put to sleep using a general anesthesia. A bronchoscope is then inserted through the airway, transmitting an image onto a large screen that allows the surgeon to see inside the trachea and bronchi.

Ultrasound is used to locate the mass on the outside of the airway.

Once the lesion or enlarged lymph node is located, a small needle is inserted through the airway wall into the mass to take a biopsy. This is done several times so that enough tissue is taken to send to a pathologist (a physician who specializes in examining and diagnosing tissue in the body) to assess whether there is cancer or another benign or treatable disease.

When only an EBUS is done, the patient may go home that day. A tentative diagnosis may be made during surgery about whether cancer is found; however, definitive diagnosis with a written pathological report is typically received within 2 to 3 days.

Symptoms that may occur after EBUS include a sore throat and coughing up a small amount of blood due to abrasion of the airway from the bronchoscope.