Abstract
We thank Drs Kumar and Chandra for their interest in our article.1Gupta D Dadhwal DS Agarwal R Gupta N Bal A Aggarwal AN Endobronchial ultrasound-guided transbronchial needle aspiration vs conventional transbronchial needle aspiration in the diagnosis of sarcoidosis.Chest. 2014; 146: 547-556Abstract Full Text Full Text PDF PubMed Scopus (145) Google Scholar We agree that the application of rapid on-site cytologic evaluation (ROSE) would have negated the need for transbronchial lung biopsy and, hence, its antecedent complications.2Yarmus L Van der Kloot T Lechtzin N Napier M Dressel D Feller-Kopman D A randomized prospective trial of the utility of rapid on-site evaluation of transbronchial needle aspirate specimens.J Bronchology Interv Pulmonol. 2011; 18: 121-127Crossref PubMed Scopus (53) Google Scholar, 3Plit ML Havryk AP Hodgson A et al.Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis.Eur Respir J. 2013; 42: 1302-1308Crossref PubMed Scopus (55) Google Scholar The use of ROSE has been shown to reduce the number of lymph node passes without loss in procedural yield in some,4Joseph M Jones T Lutterbie Y et al.Rapid on-site pathologic evaluation does not increase the efficacy of endobronchial ultrasonographic biopsy for mediastinal staging.Ann Thorac Surg. 2013; 96: 403-410Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar, 5Nakajima T Yasufuku K Saegusa F et al.Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for nodal staging in patients with lung cancer.Ann Thorac Surg. 2013; 95: 1695-1699Abstract Full Text Full Text PDF PubMed Scopus (97) Google Scholar, 6Oki M Saka H Kitagawa C et al.Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing lung cancer: a randomized study.Respiration. 2013; 85: 486-492Crossref PubMed Scopus (123) Google Scholar, 7Bonifazi M Sediari M Ferretti M et al.The role of the pulmonologist in rapid on-site cytologic evaluation of transbronchial needle aspiration: a prospective study.Chest. 2014; 145: 60-65Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar but not all,8Griffin AC Schwartz LE Baloch ZW Utility of on-site evaluation of endobronchial ultrasound-guided transbronchial needle aspiration specimens.Cytojournal. 2011; 8: 20Crossref PubMed Google Scholar studies. Despite its purported benefits, ROSE is not a widely used technique because of a lack of time and availability of certified cytologists. In fact, some pulmonologists have trained themselves to assess the adequacy of cytologic smears on-site.7Bonifazi M Sediari M Ferretti M et al.The role of the pulmonologist in rapid on-site cytologic evaluation of transbronchial needle aspiration: a prospective study.Chest. 2014; 145: 60-65Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar Thus, if ROSE is available, it should be used routinely during endobronchial ultrasound-guided transbronchial needle aspiration procedures. However, if ROSE is not available, transbronchial lung biopsy should always be performed along with endobronchial ultrasound-guided transbronchial needle aspiration in patients with suspected sarcoidosis to maximize the diagnostic yield. A “ROSE” in Every “EBUS” Keeps Transbronchial Lung Biopsy AwayCHESTVol. 146Issue 3PreviewWe read with great interest the article by Gupta et al1 in this issue of CHEST(see page 547 ) on endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). We agree with the authors that, individually, EBUS-TBNA has the highest diagnostic yield in sarcoidosis. However, we are concerned about the conclusion of combining EBUS-TBNA with transbronchial lung biopsy (TBLB) for the optimal yield. Full-Text PDF
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
