Endobronchial ultrasound elastography in mediastinal lymphadenopathy: Report of two cases and systematic review of literature

Endobronchial ultrasound elastography is new ultrasound technology that is being reported recently for the evaluation of mediastinal lymphadenopathy during endobronchial ultrasound-guided (EBUS) transbronchial needle aspiration. This modality is based on the assessment of tissue stiffness that may be useful in differentiating benign from malignant lesions. Image generation leads to colored images with different colors signifying varying degrees of stiffness. The utility of this technique has been studied to differentiate between benign and malignant lymph nodes and various methods for representation of results which include visual color estimation, quantitative color estimation, and strain ratios have been described. Herein, we report two patients with mediastinal lymphadenopathy wherein EBUS elastography was employed. We also systemically review the studies describing this technique in differentiating benign from malignant lymph nodes.