Introduction: Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a common procedure for diagnosis of pulmonary nodules and lymph nodes. During the procedure a suction syringe is used with the accumulation of aspirated material in the syringe. The diagnostic yield of such material is unknown.

Aim and objectives: This study aimed to examine the aspirated material, its clinical significance and the correlation between cytological diagnoses from the syringe in comparison to EBUS-TBNA.

Methods:A prospective singly center study. All patients referred to Meir Medical Center Pulmonary Department for EBUS-TBNA were included. In any procedure that suction material was accumulated, the material was preserved in formaldehyde and sent to a cytological examination. After which, we gathered patient demographic, clinical data, procedural data and cytological diagnosis.

Results:In total, 144 patients were included, of whom 90 men with an average age of 65.1 ±12.9. Correlation rate found between suction syringe and EBUS-TBNA was 90.1%.  11% of diagnosis were made solely from suction syringe. In 16 cases of malignancy diagnosis the material received from the suction syringe was used for advanced molecular diagnosis.

Conclusion: There is a high correlation between material received by the suction syringe and the final diagnosis. Furthermore, in approximately one-tenth of the patients diagnosis was made solely by the syringe material and abled a broader molecular testing and possibly future treatments. This study confirms that suction syringe cytological material has as outmost importance and should be regarded routinely as cytological biopsy.