Abstract
Background: Currently diagnosis of sarcoidosis, most common entity among interstital lung diseases, should be confirmed by biopsy during bronchscopy, with routine BAL. Unfortunately, sometimes there is no fluoroscopy control in bronchoscopy room, thus the efficacy of biopsies is controversial.
Aim: To evaluate the efficacy and safety of “blind” transbronchial biopsy (TBLB) with BAL during flexible bronchoscopy (FBS).
Materials: 127 patients with newly diagnosed sarcoidosis undergo the FBS with TBLB and BAL. Frequency of pneumothorax/severe bleeding, median number of tissue samples, presence of lung tissue in sample, evidence of granuloma in histology and cytology, diagnostic shanges in BAL were analyzed.
Results: There were 71 female in the group, mean age was 39.5 yrs, varied from 16 to 69. Mean duration of disease since first symptoms/chest abnormalities detection was 47,8 weeks. There were no cases of pneumothorax or severe bleeding after procedure. Mean tissue samples number was 3.1, varied from 1 to 6, median 2. Lung tissue was observed in 118/127 cases (93%). Granuloma was found in 82 out of 118 patients (64,6%), in cytology additionally granuloma was found in 7 patients, so the total efficacy was 89/127 (70%). Among the rest 38 cases with non-effective biopsy, diagnostic changes in BAL were found in 13 cases, thus total efficacy of TBLB plus BAL in sarcoidosis diagnostics was 102/127 (80,3%).
Conclusion: Bronchoscopy with TBLB and BAL even without fluoroscopy control is effective and safe method of diagnostics in newly diagnosed sarcoidosis.
- © 2011 ERS