adrenal glands using the convex curvilinear EBUS scope. In this retrospective case series, the EBUS scope was systematically used by the same operator in the same procedure for both mediastinal and extrathoracic staging in 6 consecutive patients with suspected (or known) cancers and enlarged left adrenal glands based on CT scans, showing favorable results. Up to 4–7% of patients with potentially resectable lung cancer present unilateral adrenal masses, and, of these, approximately two thirds are benign lesions. Due to the limited positive predictive values of current imaging techniques, tissue proof of extrathoracic malignant involvement is mandatory to properly stage the primary disease and determine optimal treatment [7] . EUS-FNA has been recently suggested as a highly accurate and safe alternative to the more invasive traditional procedures (i.e. percutaneous CT-guided FNA and open/laparoscopic adrenalectomies) for the assessment of left adrenal diseases [7] . Moreover, when performed by pulmonologists in a lung cancer setting, the combination with EBUS-TBNA allows a complete evaluation of tumor extent during the same procedure because of the complementary reach of different targets [8] . In this scenario, using a single scope to perform both EBUS and EUS, as proposed by Meena et al. [6] , could further optimize the cost-effectiveness of the preoperative assessment, which would easily fit with daily clinical practice due to the widespread lack of time and resources. The advent of the endobronchial ultrasound (EBUS) technique represents one of the most important advances in the field of flexible bronchoscopy. Using reflected sound waves, EBUS has revolutionized the bronchoscopist’s perspective, as it has extended the vision beyond the airways, leading to both diagnosis and mediastinal staging of cancers during the same procedure with an excellent accuracy and safety profile [1, 2] . More recently, echobronchoscopy has offered the pulmonologists another way to reach the mediastinum and lungs, as the EBUS scope can also be inserted through the esophagus, allowing access to lesions adjacent to it. In this context, the acronym EUS-FNA, which refers to endoscopic ultrasound fine-needle aspirations through the esophagus with a dedicated instrument, has become EUS-B-FNA, which stands for the same procedure, but performed with an echobronchoscope. The transesophageal approach may have the advantage of better tolerability due to the rarer occurrence of cough and the absence of cartilage that makes sampling easier. The feasibility of EUS-BFNA for mediastinal staging has already been established in a number of studies, and has shown an additional diagnostic gain in detecting mediastinal metastasis [3–5] . In this issue of Respiration , Meena et al. [6] suggest a further role for the EBUS scope in the diagnostic work-up of cancers, which goes beyond the current indications, and, in fact, for the first time, beyond the thorax. They report a successful series of biopsies from enlarged left Published online: January 9, 2015