Background:Due to absence of visible endobronchial target,the diagnostic yield of flexible bronchoscopy for peribronchial lesions has been unsatisfactory.Convex probe endobronchial ultrasound (CP-EBUS) has allowed for performing real-time transbronchial needle aspiration (TBNA) of enlarged hilar and mediastinal lymph nodes and therefore could also be used as a means of diagnosing proximal peribronchial lesions.Methods:We retrospectively analyzed the results related to 72 patients who underwent CP-EBUS for peribronchial lesions without endobronchial involvement and adjacent to three-grade bronchi based on chest computed tomography (CT) scan.We recorded the images during EBUS as well as the diagnostic results of TBNA and conventional-transbronchial lung biopsy/brush (C-TBLB/b),and final diagnoses were based on pathologic analysis and follow-up.Results:In all cases,the mass was able to be identified using EBUS in 97.2％ patients (70/72) who were performed with EBUS-TBNA + C-TBLB/b.Sixty-six patients had a final diagnosis,80.0％ patients (56/70) had malignancies,and 14.3％ patients (10/70) had benign disease.In malignancies,the diagnostic yield of C-TBLB/b was 57.1％ (32/56) and in EBUS-TBNA was 85.7％ (48/56),whereas pathologic diagnosis reached 94.6％ when EBUS-TBNA was combined with C-TBLB/b.C-TBLB/b + EBUS-TBNA also exhibited stronger potency ofhistolytic diagnosis for malignancies than either EBUS-TBNA or C-TBLB/b alone.Furthermore,there are data supporting the value of EBUS-TBNA for the diagnosis of benign lung disease.Conclusion:The combined endoscopic approach with EBUS-TBNA and C-TBLB/b is an accurate and effective method for the evaluation of peribronchial lesions,with better results than using each technique alone.