Successful Mediastinal Cryobiopsy Using the Slim UCP190F EBUS Bronchoscope and a 25G Needle: Demonstrating the Efficacy of the Ariza‐Pallares Approach

Mediastinal cryobiopsy is emerging as a powerful adjunct to traditional EBUS-TBNA, offering larger, architecturally preserved tissue samples. We describe a case demonstrating successful mediastinal cryobiopsy using the newly developed UCP190F endobronchial ultrasound (EBUS) bronchoscope in a patient with a right upper lobe lesion and mediastinal lymphadenopathy. Owing to the device's narrow 1.7 mm working channel, only 25-gauge needles (0.4 mm diameter) can be used, raising concerns regarding the feasibility of creating a sufficiently stable access tract for introducing a 1.1 mm cryoprobe for mediastinal cryobiopsy. Using the Ariza-Pallares four-step method, a navigable tunnel into station 7 was successfully created, enabling safe cryobiopsy and yielding high-quality histologic samples. This case demonstrates that mediastinal cryobiopsy can be successfully performed even with very small-gauge needles and with new-generation thin convex-probe scopes, expanding the applicability of cryobiopsy across EBUS platforms.