After discovering a lung cancer without extrathoracic metastases, the preoperative mediastinal check-up is of great importance to determine the patients operability. The 78% specificity of activity measuring FDG in a PET examination is clearly insufficient to avoid a biopsy of the incriminated lymph nodes. The investigation of a suspected malignant adenopathy justifies a complete examination by mediastinoscopy or-tomy, which are considered gold standards. The transbronchial fine needle aspiration guided by ultrasound (EBUS-TBNA) constitutes the recent evolution of TBNA, method known for 20 years now but underused. Depending on the operators skill, this new procedure needs a learning curve before being able to replace mediastinoscopy.