PT  - JOURNAL ARTICLE
AU  - Marshall L. Plit
AU  - Adrian P. Havryk
AU  - Alan Hodgson
AU  - Daniel James
AU  - Andrew Field
AU  - Sonia Carbone
AU  - Allan R. Glanville
AU  - Farzad Bashirzadeh
AU  - Anna M. Chay
AU  - Justin Hundloe
AU  - Rebecca Pearson
AU  - David Fielding
TI  - Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis
AID  - 10.1183/09031936.00128312
DP  - 2013 Nov 01
TA  - European Respiratory Journal
PG  - 1302--1308
VI  - 42
IP  - 5
4099  - http://erj.ersjournals.com/content/42/5/1302.short
4100  - http://erj.ersjournals.com/content/42/5/1302.full
SO  - Eur Respir J2013 Nov 01; 42
AB  - Rapid on-site evaluation (ROSE) of endobronchial ultrasound-guided transbronchial needle aspirates (EBUS-TBNA) has not been compared to final detailed cytological analysis in patients with suspected sarcoidosis. To assess the diagnostic accuracy of EBUS-TBNA with ROSE in patients with suspected sarcoidosis, a prospective two-centre study performed EBUS-TBNA with ROSE of cellular material followed by transbronchial lung biopsy (TBLB) and endobronchial biopsy (EBB). The diagnostic accuracy of EBUS-TBNA with ROSE was compared to the final cytological assessment and to TBLB and EBB. Analysis confirmed 49 out of 60 cases of sarcoidosis. ROSE sensitivity was 87.8% (specificity 91%, positive predictive value 97.7%). ROSE slide interpretation in combination with the final fixed slide and cell block preparations had a sensitivity of 91.8% (specificity 100%, positive predictive value 100%). 67% of patients were confirmed as having sarcoidosis on TBLB and 29% on EBB. Interobserver agreement between cytotechnologists and pathologists was very good (κ=0.91, 95% CI 0.80–1.0 and κ=0.91, 95% CI 0.79–1.0, respectively). EBUS-TBNA with ROSE has high diagnostic accuracy and interobserver agreement and informs the bronchoscopist in theatre whether additional diagnostic procedures need to be undertaken. EBUS-TBNA with ROSE should therefore be considered as the first-line investigation of sarcoidosis. Rapid on-site evaluation of EBUS-TBNA should be first-line investigation in sarcoidosis http://ow.ly/nT9Mx