Concierge respiratory diagnostics · London
Endobronchial ultrasound (EBUS), bronchoscopic ultrasound-guided biopsy — the gold-standard for mediastinal lymph node sampling.
EBUS combines a flexible bronchoscope with ultrasound imaging to biopsy mediastinal and hilar lymph nodes and lesions. The gold-standard for lung cancer staging, sarcoidosis diagnosis and unexplained lymphadenopathy — day-case with conscious sedation.
Why patients choose us
- 01
The right hands
We route you to a consultant respiratory or thoracic physician trained in EBUS — the operator who scans, samples and reports decides the answer.
- 02
Rapid on-site cytology
Where available, a cytopathologist reviews samples in the room — so we know a diagnostic sample has been taken before you leave.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What EBUS is, in one panel.
The essentials of endobronchial ultrasound — what it is, what it reaches, and what it is used for.
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Definition
Bronchoscopic ultrasound with fine-needle aspiration (EBUS-TBNA).
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Real-time guidance
Ultrasound-guided biopsy of nodes and lesions under direct vision.
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Anatomical reach
Samples mediastinal, hilar and pretracheal lymph nodes.
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Lung cancer staging
Gold-standard for N-status in non-small cell lung cancer.
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Diagnostic yield
Diagnoses sarcoidosis, TB and lymphoma from a single procedure.
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Day-case procedure
Performed under conscious sedation — home the same day.
The problem
The staging call in lung cancer is decided at EBUS.
Whether surgery is the right first move, or chemoradiotherapy is, turns on the N-status. That is decided by the tissue sample — and by the operator taking it. We route you to a consultant with dedicated EBUS training and a genuine MDT behind them.
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Suspected lung cancer on CT / PET?
We arrange staging EBUS with rapid on-site cytology where available.
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Unexplained mediastinal nodes?
One procedure to differentiate sarcoidosis, TB, lymphoma and metastatic disease.
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Molecular testing needed for therapy?
EBUS samples support the full EGFR / ALK / ROS1 / PD-L1 panel.
The journey
From consultation to recovery — what happens, in order.
One clinician from consultation to the discharge letter — a single day for the procedure itself.
Phase 1 · Before your procedure
Consultation, consent, preparation
Phase 2 · On the day
~30–45 min under sedation
Phase 3 · After
Recovery and same-day discharge
- 01
Before
Respiratory / thoracic consultation
Consultant review of your CT/PET-CT, symptoms and staging question. We confirm EBUS is the right next step.
- 02
Before
Fast six hours
Nil by mouth from six hours before the procedure. Sips of water up to two hours before, if agreed.
- 03
Before
Consent and topical lidocaine
Signed consent, throat and airway anaesthetised with lidocaine spray and gel.
- 04
On the day
Conscious sedation
Midazolam and short-acting opiate titrated by the operator — you are relaxed and comfortable throughout.
- 05
On the day
EBUS scope inserted trans-orally
The flexible ultrasound bronchoscope passes through the mouth into the trachea and main bronchi.
- 06
On the day
Real-time US-guided nodal biopsy
Ultrasound identifies each node; a fine needle samples it under direct vision. Multiple stations sampled in one sitting.
- 07
After
Recovery and same-day discharge
Two to four hours in recovery, then home with an escort. Full histology usually in five to ten working days.
Typical end-to-end from consultation to histology: 10–14 days. Urgent staging: within one week.
What it shows
When EBUS is the right procedure.
EBUS answers a specific question — what is the tissue in this lymph node, and what does it mean for staging and treatment. These are the presentations we see most.
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Mediastinal lymphadenopathy
Characterises enlarged nodes seen on CT or PET-CT, and takes tissue for diagnosis.
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N1 / N2 / N3 lung cancer nodes
Definitive nodal staging for non-small cell lung cancer — directs surgery vs chemoradiotherapy.
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Sarcoidosis granulomas (non-caseating)
High-yield diagnosis of sarcoidosis without the need for mediastinoscopy.
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TB caseating granulomas
Samples sent for AFB stain, TB culture and PCR when tuberculosis is suspected.
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Lymphoma cells
Flow cytometry from EBUS aspirate can confirm lymphoma subtypes; sometimes a core biopsy is added.
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Rapid on-site cytology
ROSE confirms diagnostic sampling in the room — fewer repeat procedures.
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Molecular / EGFR / ALK testing
EBUS samples are usually adequate for the full molecular panel used to select targeted therapy.
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Red flag: bulky mediastinal disease with SVC obstruction — urgent oncology / radiation review
Facial swelling, distended neck veins or breathlessness at rest need same-day escalation, not an outpatient slot.
Procedure types
Not all EBUS procedures are the same.
What each option on your referral is actually for.
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EBUS-TBNA (standard)
Convex-probe EBUS with 21G/22G needle aspiration of mediastinal and hilar nodes.
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EBUS with core biopsy (ProCore)
Dedicated core needle for larger tissue fragments — helpful for lymphoma architecture.
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EBUS + EUS-B combined staging
Trans-oesophageal ultrasound through the EBUS scope reaches stations behind the airway.
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Radial EBUS for peripheral nodules
Miniature probe passed into segmental airways to reach peripheral lung nodules.
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EBUS under general anaesthesia
For anxious patients, difficult airways or when combined with rigid bronchoscopy.
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Restaging EBUS post-chemoradiotherapy
Repeat sampling of previously positive nodes to confirm treatment response.
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ROSE-supported EBUS
Rapid on-site cytology in the room to confirm diagnostic yield before the scope is withdrawn.
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EBUS for staging in extra-thoracic cancer
Sampling of suspicious mediastinal nodes in breast, colorectal or renal primaries.
Our vetted London network
A small panel of clinics, we picked them.
Partners across central London with EBUS-trained respiratory physicians and a genuine lung MDT behind them. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinic in our network.
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Consultant respiratory or thoracic physicians with formal EBUS training
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Rapid on-site cytology (ROSE) available where clinically indicated
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Molecular / EGFR / ALK / PD-L1 testing on EBUS samples as standard
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Direct onward pathway to lung MDT, thoracic surgery and oncology
Safety and eligibility
A day-case procedure with a favourable safety profile.
EBUS is well-tolerated under conscious sedation — the practical points are anticoagulation, escort home, and what to watch for in the 48 hours after.
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Very low complication rate
Serious complications are uncommon in experienced hands — the safety profile is favourable versus surgical alternatives.
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Sedation, not general anaesthetic
Most cases are under conscious sedation — no ventilator, faster recovery, home the same day.
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Escort home required
You must not drive, operate machinery or make important decisions for 24 hours after sedation.
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Sore throat is common
A mild sore throat and hoarse voice for 24–48 hours is expected and settles on its own.
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Small blood-flecked cough
A little blood-tinged sputum for a day or two is normal after biopsy — heavy bleeding is not.
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Pneumothorax is rare
Small risk with peripheral radial EBUS; central EBUS-TBNA of mediastinal nodes carries a much lower risk again.
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Infection risk
Mediastinitis is rare but reported — fever, chest pain or worsening breathlessness after EBUS needs same-day review.
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Anticoagulation review
Warfarin, DOACs and dual antiplatelets need a formal pause plan — we agree this with your cardiologist and the operator in advance.
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Bring prior imaging
Original CT and PET-CT images (not just reports) sharpen node selection and shorten the procedure.
Reading your report
An EBUS report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your MDT outcome, just ask.
- 01 Header
Indication and imaging summary
Your details, the staging or diagnostic question, and a summary of the CT/PET-CT findings that shaped the procedure.
- 02 Technique
Scope, needles and stations sampled
Which bronchoscope and needle gauge were used, and which lymph node stations were interrogated and biopsied.
- 03 Findings
Cytology, histology and molecular
Per-station cytology, any core histology, and the molecular results (EGFR, ALK, ROS1, PD-L1) when applicable.
- 04 Impression
The conclusion: read this first
The diagnosis, the staging call (for cancer), and the concrete next step — read this first.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about EBUS.
Quick answers on sedation, timing, results, alternatives to mediastinoscopy, and the risks.
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What is EBUS and why do I need it?
EBUS — endobronchial ultrasound — is a flexible bronchoscope with an ultrasound probe on the tip. It lets an operator see mediastinal and hilar lymph nodes in real time and take a needle sample. It is the gold-standard test for lung cancer staging and for diagnosing sarcoidosis, TB and lymphoma affecting the mediastinum.
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Will I be awake during EBUS?
Most EBUS procedures are done under conscious sedation — you are relaxed and comfortable, often with little or no memory of the procedure, but you are not fully asleep. General anaesthesia is used in selected cases.
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How long does the procedure take?
The EBUS itself typically takes 30–45 minutes. With check-in, sedation, the procedure and recovery, plan on being at the clinic for around four hours.
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When will I get the results?
Rapid on-site cytology, where available, gives an immediate preliminary answer. The full histology and molecular results usually take five to ten working days and are discussed at the lung MDT before the next step is agreed.
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Is EBUS better than a mediastinoscopy?
For most mediastinal node stations, EBUS matches or exceeds the diagnostic yield of mediastinoscopy with fewer complications, no neck incision and same-day discharge. Mediastinoscopy remains an option in selected cases.
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What are the risks of EBUS?
The main risks are a sore throat, small volume of blood in the sputum, and — very rarely — bleeding, pneumothorax or mediastinal infection. Serious complications are uncommon in experienced hands.
Sources
Clinical guidance we lean on.
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British Thoracic Society. Guidelines on advanced diagnostic and therapeutic flexible bronchoscopy.
British Thoracic Society. Guidelines on advanced diagnostic and therapeutic flexible bronchoscopy. -
European Respiratory Society. EBUS statement and technical standards.
European Respiratory Society. EBUS statement and technical standards. -
NICE. Lung cancer: diagnosis and management (NG122).
NICE. Lung cancer: diagnosis and management (NG122). -
American College of Chest Physicians. Evidence-based guidelines for lung cancer staging.
American College of Chest Physicians. Evidence-based guidelines for lung cancer staging.
Reviewed by Pulse Atlas Editorial Board () · Last reviewed 2026-07-30 · Next review 2027-07-30 · Reading time 6 min
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In practice, in London
Why private endobronchial ultrasound ebus moves differently in London
With endobronchial ultrasound ebus, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. On the NHS, endobronchial ultrasound ebus typically sits behind a triage step and a wait that can stretch from a few weeks into months. In London’s private sector, the same appointment often lands within days. That speed matters when symptoms are disrupting work, sleep, or a plan you’d already committed to — and it’s the single most common reason people call us in the first place.
A private endobronchial ultrasound ebus pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For endobronchial ultrasound ebus specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
There are a lot of consultants in London who can technically handle endobronchial ultrasound ebus. Fewer who do it week in, week out for the exact question you’re bringing. We spend most of our time working out which is which — and being straight when a different test or a different specialist would serve you better. Everything runs to CQC, GMC and Royal College standards; the choice is about fit, not floor.
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