Abstract: Sarcoidosis, tuberculosis, malignant tumor, lymphadenitis and other diseases can cause hilar and mediastinal
lymphadenopathy, mainly including sarcoidosis, tuberculosis, tumor and lymphadenitis, but lack of characteristic clinical
manifestations and imaging changes, so the diagnosis is more difficult. Endobronchial ultrasound guided transbronchial
needle aspiration (EBUS-TBNA) is an interventional pulmonary technology for cytopathological or histopathological
diagnosis by puncturing to obtain diseased tissues, which is guided by endobronchial ultrasound (EBUS) to distinguish the
extratracheobronchial hilar and mediastinal lesions, blood vessels and lymph nodes. On the basis of EBUS-TBNA,
endobronchial ultrasound guided tunnel- drilling biopsy (EBUS-TDB) can improve the sensitivity and specificity of
diagnosis further for hilar and mediastinal diseases.

Key words: biopsy, needle, bronchoscopy, endobronchial ultrasound guided tunnel drilling biopsy