Extract EBUS-TBNA in adults is an essential tool to investigating mediastinal and hilar lymphadenopathy. It is now integral to the diagnostic and staging algorithm for lung cancer [1] as well as the diagnosis of other malignancies, lymphoma and non-malignant granulomatous conditions such as sarcoidosis and tuberculosis. The comparable diagnostic yield, along with decreased complications, has reduced the requirement for previously standard surgical biopsy sampling [2, 3].