We read with interest the recent article in CHEST (August 2009) by Dr Alain Tremblay and colleagues titled “A Randomized Controlled Trial of Standard vs Endobronchial Ultrasonography-Guided Transbronchial Needle Aspiration in Patients With Suspected Sarcoidosis.”1 It was a well-designed study in terms of the pathologic analysis; however, in the “Methods” section, the authors did not describe the bronchoscopic techniques for conventional transbronchial needle aspiration (TBNA) and endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA). There were more lymph node stations sampled with EBUS-TBNA than with the conventional TBNA. This we believe is a result of the study design, which left the decision regarding the site to sample at the discretion of the bronchoscopist. The diagnostic yield of conventional TBNA from specialized centers ranges from 72% to 90%,2-5 which is much higher than the 53.8% yield in this study. This difference can be explained by the fact that more lymph node stations were sampled per patient in other studies, and the majority of them included station 4R (right paratracheal) and station 7 (subcarinal). These lymph node stations are known to be enlarged in patients with stage I and II sarcoidosis. Many experts will agree with the notion that conventional TBNA, compared with EBUS-TBNA, is easier to perform in lymph node stations 4R and 7. A pathologist not specialized in the field of pulmonary pathology may find it difficult to analyze samples obtained via a 22-gauge EBUS-TBNA needle vs a 19-gauge conventional TBNA needle. This is because a diagnosis of sarcoidosis by histologic analysis is well standardized and easier to make, compared with cytopathologic analysis. Considering the low cost, availability, low complication rate, and ease of performance, conventional TBNA, in our opinion, should be considered the preferred technique in clinical practice.