Endobronchial ultrasound: new insight for the diagnosis of sarcoidosis

¹ Dept of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan; and Dept of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
² Dept of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
³ Dept of Pneumology and Critical Care Medicine, Thoraxklinik University of Heidelberg, Heidelberg, Germany
⁴ Dept of Basic Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan
⁵ Dept of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China

^* To whom correspondence should be addressed. E-mail: fujisawat{at}faculty.chiba-u.jp.

	Abstract

Diagnosis of sarcoidosis should be substantiated by pathological means in order well to exclude other diseases. The role of real-time endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) in diagnosis of sarcoidosis has not been reported. The purpose of this study is to evaluate the diagnostic yield of EBUS-TBNA in demonstrating the pathological feature of sarcoidosis.

Sixty-five patients with suspected sarcoidosis with enlarged hilar or mediastinal lymph nodes on computed tomography were included. Patients with suspected or known malignancy or previously established diagnosis of sarcoidosis were excluded. The convex probe endobronchial ultrasound integrated with a separate working channel was used for EBUS-TBNA. Surgical methods were performed in whom no granulomas were assessed. Patients were followed up clinically.

EBUS-TBNA was performed on a total of 77 lymph node stations in 65 patients from. The final diagnosis of sarcoidosis was given to 61 patients (93.8%). The remaining 4 patients were diagnosed as Wegener's granulomatosis (n=1) or indefinite (n=3). In patients with final diagnosis of sarcoidosis, EBUS-TBNA demonstrated noncaseating epithelioid cell granulomas in 56 patients (91.8%). No complication was reported.

EBUS-TBNA proved to be a safe procedure with a high yield for the diagnoses of sarcoidosis.

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