A bronchoscopy and ultrasound test is also called an endobronchial ultrasound scan (EBUS). You may have this test if scans show that the lymph nodes around your lung are enlarged. It helps your doctor to view the smaller airway passages.
The test creates ultrasound pictures of the lung and pleura and also the nearby lymph glands. So it can help to show the size of the tumour and whether the mesothelioma has spread into any lymph nodes.
How you have it
A bronchoscopy uses a narrow flexible tube to look at the inside of the breathing tubes (airways) in your lungs. The tube has an ultrasound probe. It uses high frequency sound waves to create pictures of the lungs and structures outside the airway walls, such as the lymph nodes.
Your doctor can see any areas that look abnormal and take samples (biopsies) to test.
You normally have this test in the endoscopy unit at the hospital. It can take around 40 minutes.
Preparing for your endobronchial ultrasound
Check your appointment letter to see how to prepare for your endobronchial ultrasound.
You sign a consent form before the test. This is a good time to make sure you ask the doctor any questions you have.
Take your usual medicines as normal unless your doctor tells you otherwise. If you take warfarin to thin your blood, you need to stop this before your bronchoscopy. Your doctor tells you when to stop it.
You have the test under local or general anaesthetic. You can’t eat or drink for a few hours beforehand. Your appointment letter tells you when you need to stop eating or drinking.
You usually have this test under a local anaesthetic. Having a local anaesthetic means you should be able to eat and drink as normal beforehand. Your doctor sprays your throat to numb it.
You might also have medicine to make you drowsy (a sedative).
Sometimes, a doctor might carry this test out under a general anaesthetic. So you will be asleep and you won't feel anything. You can't eat or drink for a few hours beforehand. Check your appointment letter to find out when you need to stop eating or drinking. Contact the department in advance if this is a problem for you, for example if you have diabetes.
You meet the anaesthetist before your test. They look after you while you have the anaesthetic and while the chest doctor is carrying out your bronchoscopy. The anaesthetist might give you some painkillers to prevent soreness.
At the hospital
When you arrive at the department, a nurse might ask you to change into a gown or you might be able to stay in your own clothes. Then your nurse shows you into the test room.
You lie on the procedure couch. Your nurse puts a small tube (cannula) into a vein in the back of your hand. They might inject sedative into the tube to help you relax.
Just before the test, your doctor sprays a local anaesthetic onto the back of your throat.
Your doctor puts a long, thin, flexible tube called a bronchoscope into your mouth and down the airway. This is a bit uncomfortable but is only for a short time. You can breathe normally but you might cough.
Once the ultrasound probe is in the right place the doctor passes a hollow needle through the bronchoscopy tube. They then take tissue samples (biopsies) to test. The doctor can also take photographs of the inside of your airways.
Your nurse checks your oxygen levels and heart rate using a clip on your finger. This doesn’t hurt.
After your endobronchial ultrasound
You won’t be able to eat or drink anything until the local anaesthetic wears off. Your throat is too numb to swallow safely at first. This usually passes off after about an hour.
You should be able to get changed into your own clothes once you feel less sleepy.
You can usually go home the same day.
Someone should collect you from the hospital if you have had a sedative or a general anaesthetic. Also, don’t drive until the day after the test because you might still be drowsy.
You need to take things easy for a day or so. You might have a sore throat for a couple of days.
Getting your results
You should get your results within 1 or 2 weeks. Contact your doctor if you haven’t heard anything after this time.
Waiting for test results or for further tests can be very worrying. You might have contact details for a specialist nurse and you can contact them for information if you need to. It may help to talk to a close friend or relative about how you feel.
The possible risks include:
You might see a small amount of blood in your spit after the test. Let your doctor or nurse know if this doesn’t go away.
See your GP straight away if your phlegm (sputum) changes colour, you start feeling more breathless or you feel as though you have a temperature.
Needing extra oxygen
You might need oxygen through a mask for some time after the bronchoscopy. If you normally have oxygen at home you might need to have more than usual for a little while.
A collapsed lung (pneumothorax)
Air or gas can collect in the space around the lung and make it collapse, but this is rare. Contact a doctor if you become short of breath or have chest pain. You have a tube put into the lung to remove the air.