How I Do It—Optimal Methodology for Multidirectional Analysis of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Samples Takahiro Nakajima,

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How I Do It—Optimal Methodology for Multidirectional Analysis of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Samples Takahiro Nakajima, MD, PhD, Kazuhiro Yasufuku, MD, PhD Journal of Thoracic Oncology Volume 6, Issue 1, Pages 203-206 (January 2011) DOI: 10.1097/JTO.0b013e318200f496 Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Multidirectional analysis of EBUS-TBNA samples. Cytologic smears are prepared for both air-dry smear and 95% ethanol-fixed smear. The histologic core is partially fixed in 10% formalin and the rest stored in −80°C. The TBNA needle is washed with saline and used for cell block and molecular testing. EBUS-TBNA, endobronchial ultrasound-guided transbronchial needle aspiration. Journal of Thoracic Oncology 2011 6, 203-206DOI: (10.1097/JTO.0b013e318200f496) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 The application of EBUS-TBNA samples. A, Diff-Quick stain for rapid on-site cytology (lymphoma). B, Papanicolaou stain for cytologic diagnosis (adenocarcinoma). C, Hematoxylin and eosin stain for histologic diagnosis (adenocarcinoma). D, Immunohistochemistry for definitive diagnosis (TTF-1, primary lung adenocarcinoma). E, Flow cytometry for assessment of lymphoma (follicular lymphoma). F, FISH for assessment of lymphoma (follicular lymphoma). G, Direct sequence for detecting EGFR gene mutation (exon 21, L858R). H, RT-PCR for detecting ALK fusion gene. I, Real-time RT-PCR for mRNA expression analysis. EBUS-TBNA, endobronchial ultrasound-guided transbronchial needle aspiration; TTF, thyroid transcription factor; FISH, fluorescence in situ hybridization; EGFR, epidermal growth factor receptor; RT-PCR, reverse-transcriptase polymerase chain reaction; ALK, anaplastic lymphoma kinase. Journal of Thoracic Oncology 2011 6, 203-206DOI: (10.1097/JTO.0b013e318200f496) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions