Rescue Diagnosis of Upper-Lobar Station 12U Lymph Nodes Using the Thin Convex-Probe EBUS Bronchoscope (BF-UCP190F): A Report of Two Cases.

BF-UCP190F (Olympus) is a newly developed thin convex-probe endobronchial ultrasound (TCP-EBUS) bronchoscope, improving access to distal bronchi. We report two cases in which TCP-EBUS enabled successful endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of the upper-lobar station 12U lymph node (#12U LN) via B3 after conventional bronchoscopic forceps sampling failed to provide a definitive diagnosis. In the first case, forceps biopsy of a left upper lobe tumour was non-diagnostic; TCP-EBUS-guided EBUS-TBNA of the left #12U LN established lung adenocarcinoma with N1 involvement. In the second case, the initial bronchoscopy yielded only cytological evidence of carcinoma without histological confirmation; TCP-EBUS-guided sampling of the right #12U LN revealed metastatic small cell carcinoma. In both cases, the pathological diagnosis of EBUS-TBNA guided subsequent treatment. These cases suggest that BF-UCP190F expands the diagnostic range of bronchoscopy and may serve as a valuable rescue technique for sampling upper lobar hilar lymph nodes in clinical practice.