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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Feb 16, 2026; 18(2): 113699
Published online Feb 16, 2026. doi: 10.4253/wjge.v18.i2.113699
Published online Feb 16, 2026. doi: 10.4253/wjge.v18.i2.113699
Diagnostic accuracy and safety of endoscopic ultrasound-guided fine needle biopsy for evaluating mediastinal pathologies
Masood Muhammad Karim, Syedda Ayesha, Adeel Ur Rehman, Section of Gastroenterology, Department of Medicine, Aga Khan University, Karachi 74800, Sindh, Pakistan
Abdul Hadi Shahid, Muhammad Salman, Danaish Kumar, Medical College, Aga Khan University, Karachi 74800, Sindh, Pakistan
Zeeshan Uddin, Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi 74800, Sindh, Pakistan
Co-first authors: Masood Muhammad Karim and Syedda Ayesha.
Co-corresponding authors: Masood Muhammad Karim and Adeel Ur Rehman.
Author contributions: Karim MM and Rehman AU contribute equally to this study as co-corresponding authors. Karim MM and Ayesha S contribute equally to this study as co-first authors. Karim MM, Salman M, Ayesha S, and Kumar D contributed to structuring the manuscript; Karim MM, Ayesha S, and Shahid AH contributed to the project’s conception and design; Karim MM played a significant role in identifying the topic, providing valuable insights into the data; Ayesha S, Shahid AH, Salman M, and Kumar D contributed to collecting and cleaning data; Shahid AH conducted a literature search and wrote the manuscript; Salman M is interpreting the findings; Kumar D assisted in conducting a literature search; Uddin Z played a substantial role in interpreting the findings of fine-needle biopsy and histological slides, and proofreading the manuscript; Rehman AU supervised the project, provided a critical review, made final edits, and ensured its accuracy and clarity with his expertise.
Institutional review board statement: This study was reviewed and approved as an exemption by the Aga Khan University Hospital-Ethics Review Committee, with ethical code number No. 6874-25427.
Informed consent statement: Informed consent from patients was exempted in this study, as approved by the institutional ethical review committee, because the study did not involve any direct human interaction and utilized data obtained after each patient had provided written consent for treatment. Furthermore, all patient identifiers were removed during data entry, and patient confidentiality was fully maintained.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets generated and/or analyzed during the current study are not publicly available owing to confidentiality and institutional ethical policies, but can be obtained from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Adeel Ur Rehman, Assistant Professor, Section of Gastroenterology, Department of Medicine, Aga Khan University, Karachi 74800, Sindh, Pakistan.
Received: September 2, 2025
Revised: October 2, 2025
Accepted: December 17, 2025
Published online: February 16, 2026
Processing time: 155 Days and 19.5 Hours
Revised: October 2, 2025
Accepted: December 17, 2025
Published online: February 16, 2026
Processing time: 155 Days and 19.5 Hours
Core Tip
Core Tip: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is a minimally invasive technique that enables accurate tissue sampling of mediastinal lesions. In this single-centre study from Pakistan, EUS-FNB demonstrated excellent diagnostic performance, with 94.8% diagnostic yield, 88.9% sensitivity, and 100% specificity, while maintaining a strong safety profile without procedure-related complications. The study highlights the value of EUS-FNB in guiding management of both benign and malignant mediastinal pathologies and addressing a critical evidence gap in low- and middle-income country settings, where data remain limited.