Case Title: EBUS guided Transbronchial Cryonodal biopsy of Subcentimetric (8mm) Subcarinal lymphnode.
Authors: Dr.Sowmya Kongara, Dr.Praveen Valsalan, Dr.Sharon Anne Thomas, Dr.Aparna S Nirmal, Dr.Vineetha K

Submitter: Sowmya Kongara, MD
Description: Case vignette: A 40yr old male patient, known hypertensive. Presented with complaints of b/l lower limb swelling and papular lesions - ?Erythema nodosum. No respiratory complaints.
CT chest - Tiny Lymphnodes in prevascular, paratracheal, precarinal, hilar, interlobar, subcarinal groups largest 6mm in short axis.Few lymphnodes appeared calcified.
Procedure : Multiple EBUS-TBNA passes made with Olympus 21G needle from Station 7 but sample is insufficient. Cryonodal biopsies with 1.1mm cryoprobe was taken from Station-7
HPE report -
TBNA- inconclusive
ROSE negative
Cryonodal biopsy- GRANULOMATOUS INFLAMMATION. No necrosis/malignancy.
1. Cryo nodal biopsy is a versatile tool to biopsy very small nodes, more so when rose is inconclusive.
2. Cryonodal biopsy can be done even in subcentimetric node when there is less chance of to make TBNA passes.
3. Subcentimetric nodes must not be neglected.It should be sampled if clinically significant.