TUS imaging, diagnostic yield, and complications of TUS-guided FNAB were reassessed. The records of 133 patients with MPM and 801 patients with LC were analyzed. In 55 of the patients with MPM and in all 801 of those with LC (2008-2013), TUS-guided FNAB was performed using 20-gauge needles and US transducers with a central hole for needle passage.3 Such thin needles provided specimens of adequate size (length: 1.0-2.5 cm). In 20 patients, the procedure was repeated for insufficient sampling. Four patients had partial, self-limited pneumothorax; no severe complication was observed. The TUS signs observed in histologically confirmed MPM were irregular thickening of the pleural line (> 5.0 mm) and associated micronodules (5-10 mm); a lower percentage showed plaque nodulations (5-10 mm), all with slight or relevant pleural effusion. We emphasize that the concordance of CT images and TUS is greater in patients with MPM than in patients with LC, probably due to the strictly pleural-subpleural position of the tumor mass (Fig 1). Moreover, the FNAB-dedicated probes3 enable reaching the lesion to be biopsied under the coaxial view (Fig 1C), getting specimens of length, thickness, and quality adequate for pathology assessment.